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

Xinnian Yang; Jiayin Zhang; Yanli Song; Dengqiang Jia; Qingqi Hong; Yiqiang Zhan; Xiang Sean Zhou; Yining Dong; Yining Wang; Dijia Wu; Dinggang Shen

doi:10.1038/s41467-025-64940-8

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

Xinnian Yang (Co-first Author)
, Jiayin Zhang (Co-first Author)
, Yanli Song
, Dengqiang Jia
, Qingqi Hong
, Yiqiang Zhan
, Xiang Sean Zhou
, Yining Dong
, Yining Wang^*
, Dijia Wu^*
, Dinggang Shen^*

^*Corresponding author for this work

Department of Data Science

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

2 Citations (Scopus)

3 Downloads (CityUHK Scholars)

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. © The Author(s) 2025.

Original language	English
Article number	10616
Journal	Nature Communications
Volume	16
Online published	22 Nov 2025
DOIs	https://doi.org/10.1038/s41467-025-64940-8
Publication status	Published - 2025

Funding

We gratefully acknowledge the support of Beijing Natural Science Foundation (No. Z210013) (Y.W., D.W.), National Key Research and Development Program of China (No. 2022YFE0209800) (D.W.), National Natural Science Foundation of China (Nos. U23A20295 (D.S.), 82441023 (D.S.), 62131015 (D.S.), 22322816 (Y.D.), 82471982 (J.Z.), 62471418 (Q.H.)), the InnoHK initiative of the Innovation and Technology Commission of the Hong Kong Special Administrative Region Government,\u00A0Shanghai Municipal Central Guided Local Science and Technology Development Fund (No. YDZX20233100001001) (D.S.), Key Project of Shanghai Municipal Education Commission (No. 2024AIZD017) (J.Z.), City University of Hong Kong Project (No. 9610640) (Y.D.), and HPC Platform of ShanghaiTech University (D.S.).

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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

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. {\textcopyright} The Author(s) 2025.",

author = "Xinnian Yang and Jiayin Zhang and Yanli Song and Dengqiang Jia and Qingqi Hong and Yiqiang Zhan and Zhou, \{Xiang Sean\} and Yining Dong and Yining Wang and Dijia Wu and Dinggang Shen",

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journal = "Nature Communications",

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T1 - Deciphering age- and sex-specific patterns of coronary artery atherosclerosis from a large Chinese cohort

AU - Yang, Xinnian

AU - Zhang, Jiayin

AU - Song, Yanli

AU - Jia, Dengqiang

AU - Hong, Qingqi

AU - Zhan, Yiqiang

AU - Zhou, Xiang Sean

AU - Dong, Yining

AU - Wang, Yining

AU - Wu, Dijia

AU - Shen, Dinggang

PY - 2025

Y1 - 2025

N2 - 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. © The Author(s) 2025.

AB - 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. © The Author(s) 2025.

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U2 - 10.1038/s41467-025-64940-8

DO - 10.1038/s41467-025-64940-8

M3 - RGC 21 - Publication in refereed journal

C2 - 41274881

SN - 2041-1723

VL - 16

JO - Nature Communications

JF - Nature Communications

M1 - 10616

ER -

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

Abstract

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