Prevalence and Distribution of Silent Coronary Atherosclerotic Plaques in Asymptomatic Urban Indian Population Results from the Largest A.I. powered C.T Heart Scan Study on Indian Population (UNITED A.I-CAC Registry)

Abstract Background and Objectives: Coronary artery disease (CAD) in Indians occurs a decade earlier than in Western populations. Artificial intelligence powered coronary artery calcium (AI-CAC) scan is a useful method for detecting silent atherosclerotic plaque and preventing heart attacks. However, large-scale data in Indians remain limited. This study shows the prevalence and distribution of silent CAD in the asymptomatic urban Indian population. Materials and Methods: This retrospective cross-sectional study included 10,004 adults who underwent voluntary CAC scanning on a Siemens 384-slice cardiac computed tomography scanner over 2 year period. CAC scores were calculated using the Agatston method. Vessel involvement and severity were assessed. Age, gender-stratification, along with the coronary age gap, were analyzed. Results: Of 10,004 subjects, 6955 (69.5%) were men and 3049 (30.5%) women, with a mean age of 47.3 ± 14.1 years. CAC >0 was detected in 3160 individuals (31.6%). CAC prevalence increased markedly with age: from 2.39% (under 40) to 76.48% (60+ age group). Among CAC-positive individuals, LAD was involved in 88.01%, 67% showing multivessel disease. Severe CAC (≥300) was present in 759 subjects (7.6%). Mean coronary age-gap was highest (3.49 years) for 40–60 years age group. Conclusion: This landmark largest CAC study on the Indian population demonstrates silent atherosclerosis in Indians at younger ages. Data analyses support the incorporation of this scan into preventive cardiology programs in India from the age of 40 years (calculated cutoff age: 42 years (male) and 48 years (female)). This helps in early identification of atherosclerosis and thus prevention of heart attacks through aggressive risk factor modification.