Abstract 17969: Coronary Plaque Composition in Symptomatic African American and White Patients: Insights From with Coronary CT Angiography
Background: Despite worse cardiovascular outcomes, previous studies have demonstrated that African American (AA) patients have lower coronary calcium score (CCS) compared to Caucasians (CA). The aim of this analysis is to assess the racial differences in coronary plaque burden and composition in symptomatic patients undergoing coronary CT Angiography (CCTA).
Methods: A total of 838 symptomatic patients (47% male, mean age: 57±12years) underwent CCS and CCTA for evaluation of chest pain syndrome. Each coronary artery segment was evaluated for the presence of and type (calcified, non-calcified, mixed) of atherosclerotic plaque. Presence and extent of atherosclerotic plaque was compared between AA and CA patients using multivariate regression.
Results: African American patients (n=325) were more often males with higher prevalence of diabetes (23% vs. 18%, p=0.044) and hypertension. They less often had any detectable coronary calcifications (46% vs. 55%, p=0.01) as well as lower median CCS score (0 vs. 10, p<0.0001). In univariate analysis, AA patients had a lower prevalence of calcified plaque (34% vs. 42%, p=0.033) with no differences in non-calcified and mixed plaques (Figure). This continued to be significant after adjusting for potential confounders. (OR of AA having more than 2 calcified plaques compared to CA: 0.52, 95%-CI: 0.34 - 0.83, p=0.007).
Conclusion: Our analysis suggests that in comparison to Caucasians, symptomatic African-American patients have lower burden of calcified plaque without increase in the presence of non-calcified plaque or mixed plaques as detected by CCTA.
- © 2011 by American Heart Association, Inc.