Abstract 17123: Correlation Between Ethnicity and Extent of Coronary Artery Disease on Coronary CT Angiography: Results From the Advanced Cardiovascular Imaging Consortium
Background: Although racial differences in prevalence of coronary artery disease (CAD) are well-known, race is not included in widely used risk assessment algorithms. The purpose of this study was to establish if race was an independent predictor of significant CAD (>50% stenosis) on coronary CT angiography (CCTA).
Methods: Patients with no known CAD undergoing CCTA at 41 institutions and enrolled in a large statewide registry, the Advanced Cardiovascular Imaging Consortium (ACIC) between July 2007 and April 2011 were included. Demographics, risk factors, Framingham Risk Scores (FRS), pre-test CAD likelihood and extent of CAD on CCTA were compared between racial groups. Multivariable models were constructed adjusting for FRS, gender, pre-test likelihood and race to predict >50% stenosis.
Results: Of the 19,105 patients studied, 86.8% were self-identified as Caucasian, 11.7% African and 1.5% Asian. Caucasians were older, more often asymptomatic, had history of peripheral vascular disease and atrial fibrillation while Africans were more often obese with history of diabetes, hypertension, stroke, congestive heart failure and chronic kidney disease (p<0.0001). On CCTA, Caucasians more often had a stenosis >50% compared to Africans and Asians (16.5% vs. 9% and 12.8%, respectively, p<0.0001). On multivariate analysis, Caucasian race remained a significant and independent predictor of >50% stenosis on CCTA in men and women, with incremental value over FRS and pre-test likelihood (Table).
Conclusions: Risk factors and extent of CAD differ significantly among ethnicities. In this large population, race/ethnicity was an independent predictor of significant CAD on CCTA, suggesting that it should be considered in risk assessment schemes.
- © 2011 by American Heart Association, Inc.