Abstract 15481: Statin Use and Plaque Morphology in South Asians and Non South Asians: a Coronary Computed Tomography Study
Objective: To assess the association between the use of HMG Co A reductase inhibitors (statin medications) and coronary artery plaque morphology (PM) in South Asians (SA) vs. Non South Asians (NSA).
Methods: Consecutive Coronary CT Angiograms (CCTAs) performed at a tertiary referral center between May 2008 and September 2010 were reviewed. Patients with known CAD or un-interpretable scans were excluded. Patients’ demographics and self reported cardiac risk factors (CRF) were obtained. Statin use was determined by reviewing patient health records. A validated unique name recognition tool identified those of SA ethnicity, all others were regarded as NSA.Experienced physicians interpreted CCTAs using an 18-segment model. Each segment’s PM was reported as either calcified (CP), non-calcified (NCP) or mixed (MP) plaque.The association between statin use and PM in SA versus NSA was studied using the Independent Sample T test and adjusted for cardiac risk factors.
Results: The cohort of n=937 consisted of n=165 (18%) SA and n=772 NSA patients. Both SA and NSA had similar rates of male sex (61%) and normal CCTA scans (42%). The use of statins at the time of CCTA was n=73 (45%) amongst SA and n= 372 ( 48%) amongst NSA patients. In both SA and NSA patients statin use was associated with a significantly higher rates of hypertension, diabetes and dyslipidemia (p< 0.02 for all). After adjusting for these risk factors, amongst NSA, statin treated patients had more CP and MP and less NCP compared to patients who were not on statin (CP: 27% vs. 17%, p=<0.001; MP: 18% vs. 11%, p <0.001; NCP: 6% vs. 11%, p<0.02). However, in SA patients, statin use was associated with more CP (25% vs. 12%, p<0.01), while there was no statistically significant difference between MP (16% vs. 16%, p<0.4) and NCP (14% vs. 14%, p<0.7).
Conclusion: Statin medications have been associated with coronary artery plaque stabilization in numerous studies. Our study suggests a potential differential association of statin treatment in SA, as compared with NSA. The difference in plaque morphology by statin use by SA status may aid in our understanding of differences in cardiac event rates amongst this high risk ethnic subgroup. Analysis of plaque morphology and the effect of statin use in this group warrants further study.
- © 2011 by American Heart Association, Inc.