Abstract Body (Do not enter title and authors here): Background: Coronary artery calcification (CAC) is an established marker of subclinical atherosclerosis and predictor of cardiovascular events. Despite extensive research on CAC in various populations, data focusing on Arab populations, particularly asymptomatic individuals, is limited.
Methods: We analyzed data from 2,739 asymptomatic self-referred Arabs included in the Kuwait Hospital Awareness Campaign for Early Detection of Atherosclerotic Coronary Artery Disease study. Traditional CVD risk factors were assessed, and ECG-gated cardiac CT imaging was used to measure using the Agatston method.
Results: The mean±SD age of the sample was 48.4±9.8 and 41.8% were females. Kuwaitis comprised 61.6% of the sample, Egyptians 20.5%, and Levantines 16.4%. CAC was >0 in 32.3%, ≥100 in 11.5%, and ≥400 in 4% of the sample. CAC prevalence increased with age and was higher in Arab males with a 12 year earlier onset in males than females. The 50^th, 75^th, 90^th and 95^th percentiles of CAC for Arab females were, 0, 0, 39, and 167 and for males were 0, 25, 191, and 470, respectively. The presence of CAC was associated with traditional risk factors including diabetes, smoking, hypertension and LDL-C. Levantines and Kuwaitis had the highest prevalence of CAC and CVD risk factors; these groups were independently associated with higher CAC levels. In all age and sex subgroups except older males, the 75^th percentiles of CAC were below 100. Therefore, a larger number of subjects were identified as high risk using the 75^th age- and sex-specific CAC percentile than with CAC≥100 (19.3% vs 11.5%).
Conclusion: This study provides comprehensive insights into subclinical atherosclerosis in asymptomatic Arabs, emphasizing the importance of early risk stratification for primary CVD prevention using CAC scoring. Our findings highlight that Arabs are not a homogeneous group with regards to prevalence of CVD risk factors and CAC. This study underscores the need to consider both absolute and age- and sex-specific CAC percentile values to inform primary prevention strategies in this predominantly young population.