{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:24:12Z","timestamp":1788992652546,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The clinical use of coronary artery calcium (CAC) scoring for risk stratification in Japan is limited by the absence of population\u2010specific reference data, as applying Western\u2010derived thresholds is inappropriate because of known ethnic variations. This study aimed to establish the first comprehensive, age\u2010 and sex\u2010specific CAC reference values for a healthy Japanese population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this single\u2010center retrospective study, we analyzed data from 4891 asymptomatic Japanese adults (63.2% men; median age, 58\u2009years) without a history of atherosclerotic cardiovascular disease or diabetes. Age\u2010 and sex\u2010specific CAC percentile curves were generated using nonparametric regression modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Men exhibited a higher CAC burden than women, with scores increasing with age in both sexes. The relationship between detectable CAC (CAC &gt;0) and age was nonlinear: concave down for men and concave up for women, indicating different progression patterns. Compared with MESA (Multi\u2010Ethnic Study of Atherosclerosis) data, the Japanese cohort had a markedly lower CAC burden than White participants and systematically lower scores than Chinese American women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study provides the first large\u2010scale, age\u2010 and sex\u2010specific CAC reference values for a healthy Japanese population. The generated percentile curves offer a practical tool for clinicians to immediately assess a patient\u2019s CAC burden relative to their peers, underscoring that using foreign\u2010derived thresholds is inappropriate for risk stratification in Japan.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046403","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:23:50Z","timestamp":1770895430000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Age\u2010 and Sex\u2010Specific Distribution and Reference Values of Coronary Artery Calcium in a Large Asymptomatic Japanese Cohort"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3071-5803","authenticated-orcid":false,"given":"Hidenobu","family":"Takagi","sequence":"first","affiliation":[{"name":"Tohoku University","place":["Sendai, Japan"]},{"name":"Tohoku University Hospital","place":["Sendai, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4231-7378","authenticated-orcid":false,"given":"Masaharu","family":"Hirano","sequence":"additional","affiliation":[{"name":"Tohoku University","place":["Sendai, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1635-7730","authenticated-orcid":false,"given":"Takashi","family":"Asano","sequence":"additional","affiliation":[{"name":"Yamanakako Clinic","place":["Minamitsuru, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4518-6458","authenticated-orcid":false,"given":"Kensuke","family":"Nishimiya","sequence":"additional","affiliation":[{"name":"Tohoku University Graduate School of Medicine","place":["Sendai, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Obara","sequence":"additional","affiliation":[{"name":"Tohoku University","place":["Sendai, Japan"]},{"name":"Tohoku University","place":["Sendai, Japan"]},{"name":"Tohoku University Hospital","place":["Sendai, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ota","sequence":"additional","affiliation":[{"name":"Tohoku University","place":["Sendai, Japan"]},{"name":"Tohoku University Hospital","place":["Sendai, Japan"]},{"name":"Tohoku University Hospital","place":["Sendai, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1073-2913","authenticated-orcid":false,"given":"Junichi","family":"Taguchi","sequence":"additional","affiliation":[{"name":"Tokyo Midtown Clinic","place":["Minato, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0931-9942","authenticated-orcid":false,"given":"Kei","family":"Takase","sequence":"additional","affiliation":[{"name":"Tohoku University","place":["Sendai, Japan"]},{"name":"Tohoku University Hospital","place":["Sendai, Japan"]},{"name":"Tohoku University","place":["Sendai, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00367-2"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182051bab"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000678"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-23-0285"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00187-6"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.02.055"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(64)91625-3"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072100"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy217"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000157730.94423.4B"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2020.01.006"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-016-0892-2"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002424"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2009.161"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-T"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2022.07.002"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.580696"},{"key":"e_1_3_1_20_2","volume-title":"The R Project for Statistical Computing","author":"R Core Team","unstructured":"R Core Team . 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