Abstract MP52: Association of 10-year and Lifetime Predicted Cardiovascular Disease Risk with Subclinical Atherosclerosis in South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study
Background: Short-term (10-year) coronary heart disease (CHD) risk prediction models appear to underestimate risk in South Asians (SAs), who develop risk factors and CHD at younger ages compared to other populations. Further, the association of conventional risk prediction models with intermediate endpoints, such as coronary artery calcium (CAC), has not been described in U.S. SAs.
Methods: MASALA is population-based cohort designed to assess risk factors for CVD development among U.S. SAs, ages 40-84, free of clinical CVD. We estimated ATP III 10-year CHD risk and lifetime CVD risk for participants enrolled to date (n=649), using a published algorithm based on conventional risk factors (age, sex, total and HDL cholesterol, smoking, SBP, antihypertensive treatment, and diabetes), permitting stratification into 3 groups: low 10-year (<10%)/low lifetime (<39%) predicted risk, low 10-year (<10%)/high lifetime (≥39%) predicted risk, and high 10-year (≥10%) predicted risk or diagnosed diabetes. Agatston CAC score and common carotid intima media thickness (CIMT) were compared across the 3 risk strata.
Results: Participants’ mean age was 56 and most were non-US-born (see Table). Fifty percent of men and 83% of women were at low short-term predicted risk for a CHD event; however, 66% of those with low short-term risk had high lifetime risk based on aggregate risk factor burden. Only 6% of men and 12% of women had an all-optimal risk factor profile. Participants with high short-term risk (50% of men and 17% of women) had a significantly higher CAC prevalence and higher CIMT than those with low lifetime risk.
Conclusion: This is the first study to estimate lifetime predicted CVD risk in U.S. SAs, the second fastest growing U.S. minority and one with disparate CHD rates. The lifetime risk algorithm identified a substantial proportion of SAs as low short-term/high lifetime risk. Longitudinal follow-up data from MASALA will allow us to determine relationships between CVD risk prediction, subclinical atherosclerosis, and CVD events in SAs.
- © 2013 by American Heart Association, Inc.