{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:05:40Z","timestamp":1780322740239,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T00:00:00Z","timestamp":1460678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coronary artery calcium (<jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>) has been demonstrated to independently predict the risk of cardiovascular events and all\u2010cause mortality, especially among White populations. Although the population distribution of <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> has been determined for several White populations, the distribution in ethnically admixed groups has not been well established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>The CAC distribution, stratified for age, gender and race, is similar to the previously described distribution in the MESA study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Brazilian Longitudinal Study of Adult Health (<jats:styled-content style=\"fixed-case\">ELSA<\/jats:styled-content>\u2010Brasil) is a prospective cohort study designed to investigate subclinical cardiovascular disease in 6 different centers of Brazil. Similar to previous studies, individuals with self\u2010reported coronary or cerebrovascular disease and those treated for diabetes mellitus were excluded from analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Percentiles of <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> distribution were estimated with nonparametric techniques. The analysis included 3616 individuals (54% female; mean age, 50 years). As expected, <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> prevalence and burden were steadily higher with increasing age, as well as increased in men and in White individuals. Our results revealed that for a given <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> score, the <jats:styled-content style=\"fixed-case\">ELSA<\/jats:styled-content>\u2010derived <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> percentile would be lower in men compared with the Multi\u2010Ethnic Study of Atherosclerosis (<jats:styled-content style=\"fixed-case\">MESA<\/jats:styled-content>) and would be higher in women compared with <jats:styled-content style=\"fixed-case\">MESA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our sample of the Brazilian population, we observed significant differences in <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> by sex, age, and race. Adjusted for age and sex, low\u2010risk individuals from the Brazilian population present with significantly lower <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> prevalence and burden compared with other low\u2010risk individuals from other worldwide populations. Using <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\u2010derived percentiles in Brazilian individuals may lead to overestimating relative <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> burden in men and underestimating relative <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> burden in women.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22539","type":"journal-article","created":{"date-parts":[[2016,4,15]],"date-time":"2016-04-15T11:29:09Z","timestamp":1460719749000},"page":"352-359","source":"Crossref","is-referenced-by-count":51,"title":["Age, Gender, and Race\u2010Based Coronary Artery Calcium Score Percentiles in the Brazilian Longitudinal Study of Adult Health (<scp>ELSA<\/scp>\u2010Brasil)"],"prefix":"10.1002","volume":"39","author":[{"given":"Alexandre C.","family":"Pereira","sequence":"first","affiliation":[{"name":"Center for Clinical and Epidemiologic Research University of S\u00e3o Paulo  S\u00e3o Paulo 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Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murilo","family":"Foppa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Federal University  Rio Grande do Sul, Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Blaha","sequence":"additional","affiliation":[{"name":"Johns Hopkins Ciccarone Center for the Prevention of Heart Disease  Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela M.","family":"Bensenor","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"School of Medicine University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo A.","family":"Lotufo","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiologic Research University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"School of Medicine University of S\u00e3o Paulo  S\u00e3o Paulo 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