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Deciphering age- and sex-specific patterns of coronary artery atherosclerosis from a large Chinese cohort

Author

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  • Xinnian Yang

    (City University of Hong Kong, School of Data Science
    ShanghaiTech University, School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices
    Hong Kong Centre for Cerebro-cardiovascular Health Engineering)

  • Jiayin Zhang

    (Shanghai Jiao Tong University School of Medicine, Department of Radiology, Shanghai General Hospital)

  • Yanli Song

    (Ltd., Shanghai United Imaging Intelligence Co.)

  • Dengqiang Jia

    (Hong Kong Centre for Cerebro-cardiovascular Health Engineering
    Macao Polytechnic University, Faculty of Applied Sciences)

  • Qingqi Hong

    (Xiamen University, National Institute for Data Science in Health and Medicine)

  • Yiqiang Zhan

    (Ltd., Shanghai United Imaging Intelligence Co.)

  • Xiang Sean Zhou

    (Ltd., Shanghai United Imaging Intelligence Co.)

  • Yining Dong

    (City University of Hong Kong, School of Data Science)

  • Yining Wang

    (Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital)

  • Dijia Wu

    (Ltd., Shanghai United Imaging Intelligence Co.)

  • Dinggang Shen

    (ShanghaiTech University, School of Biomedical Engineering & State Key Laboratory of Advanced Medical Materials and Devices
    Ltd., Shanghai United Imaging Intelligence Co.
    Shanghai Clinical Research and Trial Center)

Abstract

Coronary artery disease poses a significant public health threat, and coronary computed tomography angiography is the preferred imaging modality for diagnosis and risk assessment of coronary artery disease through plaque evaluation. However, understandings of how atherosclerotic characteristics vary by age and sex remains limited due to challenges in manual quantitative plaque assessment. Here, we conducted a retrospective, consecutive, multi-center Chinese cohort study of 16,300 patients undergoing clinically indicated coronary computed tomography angiography that revealed multi-level quantitative patterns of atherosclerosis stratified by age and sex. We found that females experienced a delayed atherosclerosis onset by approximately 20 years compared to males, with plaque burden increasing nonlinearly with age and accelerating more evidently after menopause. The built coronary atlas identified plaque clusters, primarily within proximal segments of major coronary arteries, slightly upstream side branch bifurcations. Our findings provide deeper insights into coronary atherosclerosis in the Chinese population, supporting more tailored prevention strategies.

Suggested Citation

  • Xinnian Yang & Jiayin Zhang & Yanli Song & Dengqiang Jia & Qingqi Hong & Yiqiang Zhan & Xiang Sean Zhou & Yining Dong & Yining Wang & Dijia Wu & Dinggang Shen, 2025. "Deciphering age- and sex-specific patterns of coronary artery atherosclerosis from a large Chinese cohort," Nature Communications, Nature, vol. 16(1), pages 1-16, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-64940-8
    DOI: 10.1038/s41467-025-64940-8
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