European Journal of Epidemiology

, Volume 27, Issue 9, pp 673–687 | Cite as

Coronary artery calcium distributions in older persons in the AGES-Reykjavik study

  • Elias Freyr Gudmundsson
  • Vilmundur Gudnason
  • Sigurdur Sigurdsson
  • Lenore J. Launer
  • Tamara B. Harris
  • Thor AspelundEmail author


Coronary Artery Calcium (CAC) is a sign of advanced atherosclerosis and an independent risk factor for cardiac events. Here, we describe CAC-distributions in an unselected aged population and compare modelling methods to characterize CAC-distribution. CAC is difficult to model because it has a skewed and zero inflated distribution with over-dispersion. Data are from the AGES-Reykjavik sample, a large population based study [2002–2006] in Iceland of 5,764 persons aged 66–96 years. Linear regressions using logarithmic- and Box-Cox transformations on CAC+1, quantile regression and a Zero-Inflated Negative Binomial model (ZINB) were applied. Methods were compared visually and with the PRESS-statistic, R2 and number of detected associations with concurrently measured variables. There were pronounced differences in CAC according to sex, age, history of coronary events and presence of plaque in the carotid artery. Associations with conventional coronary artery disease (CAD) risk factors varied between the sexes. The ZINB model provided the best results with respect to the PRESS-statistic, R2, and predicted proportion of zero scores. The ZINB model detected similar numbers of associations as the linear regression on ln(CAC+1) and usually with the same risk factors.


Coronary artery calcium Epidemiology Older persons Skewed distribution ZINB Statistical modelling 



Coronary artery calcium


Coronary artery disease


Cardiovascular disease


Confidence interval


Carotid intima medial thickness


High density lipoprotein


Odds ratio


Standard deviation


Transient ischemic attack


Zero inflated negative binomial



This work was supported by the National Institutes of Health (NIH) contract N01-AG-12100; the National Institute on Aging, in part by the Intramural Research Program; Hjartavernd (the Icelandic Heart Association); and the Althingi (the Icelandic Parliament).

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Elias Freyr Gudmundsson
    • 1
  • Vilmundur Gudnason
    • 1
    • 2
  • Sigurdur Sigurdsson
    • 1
  • Lenore J. Launer
    • 3
  • Tamara B. Harris
    • 3
  • Thor Aspelund
    • 1
    • 4
    Email author
  1. 1.Icelandic Heart Association, Research InstituteKopavogurIceland
  2. 2.Faculty of MedicineUniversity of IcelandReykjavikIceland
  3. 3.Laboratory of Epidemiology, Demography, and Biometry, Intramural Research ProgramNational Institute on AgingBethesdaUSA
  4. 4.Faculty of Medicine, Public HealthUniversity of IcelandReykjavikIceland

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