Coronary Plaque Volume in an Asymptomatic Population: Miami Heart Study at Baptist Health South Florida

Background: Coronary computed tomography angiography (CTA)-derived plaque burden is associated with the risk of cardiovascular events and is expected to be used in clinical practice. Understanding the normative values of computed tomography–based quantitative plaque volume in the general population is clinically important for determining patient management. Objectives: This study aimed to investigate the distribution of plaque volume in the general population and to develop nomograms using MiHEART (Miami Heart Study) at Baptist Health South Florida, a large community-based cohort study. Methods: The study included 2,301 asymptomatic subjects without cardiovascular disease enrolled in MiHEART. Quantitative assessment of plaque volume was performed by using artificial intelligence–guided quantitative coronary computed tomography angiography (AI-QCT) analysis. The percentiles of the plaque distribution were estimated with nonparametric techniques. Results: Mean age of the participants was 53.5 years, and 50.4% were male. The median total plaque volume was 54 mm³ (Q1-Q3: 16-126 mm³) and increased with age. Male subjects had greater median total plaque volume than female subjects (80 mm³ [Q1-Q3: 31-181 mm³] vs 34 mm³ [Q1-Q3: 9-85 mm³]; P < 0.001); there was no difference according to race/ethnicity (Hispanic 53 mm³ [Q1-Q3: 14-119 mm³] vs non-Hispanic 54 mm³ [Q1-Q3: 17-127 mm³]; P = 0.756). The prevalence of subjects with total plaque volume ≥20 mm³ was 81.5% in male subjects and 61.9% in female subjects. Younger individuals had a greater percentage of noncalcified plaque. Conclusions: The large majority of study subjects had plaque detected by using AI-QCT. Furthermore, age- and sex-specific nomograms provided information on the plaque volume distribution in an asymptomatic population.