Abstract 16999: Can CCTA Enhance Our Understanding of Coronary Artery Disease in South Asian Population?
Background: Compared to age-matched Caucasians, South Asians (SA) have a higher prevelance of coronary artery disease (CAD) related morbidity and mortality. We sought to evaluate the use of coronary CT angiography (CCTA), in enhancing our understanding of the pathogenesis of CAD in SA by comparing plaque characteristics in SA and non South Asians (NSA).
Methods: Consecutive CCTAs performed at an experienced quaternary center between January 2008 and September 2011 were reviewed. Patient demographics and self-reported cardiac risk factors were available. Society of Cardiovascular Computed Tomography (SCCT) suggested 18-segment model was used for interpretation of CCTAs . Each segment’s degree of stenosis was quantified. The Segment scores were summed to generate a total stenosis score (TSS). Each segment’s plaque morphology (PM) was reported as either calcified plaque (CP), non calcified plaque (NCP) or partially calcified plaque (PCP). Comparison of plaque morphology, plaque burden and the association between the individual cardiac risk factors and plaque characteristics were made between SA and NSA.
Results: The total cohort (n= 932) was made up of n= 161 (17%) SA and n= 771 (83%) NSA. The mean age was 54.2± 11.5 and 59.8 ± 12.8 years in the SA and NSA groups respectively(P<0.003). Both SA and NSA had similar TSS and number of proximal plaques. Corrected for age, analysis of PM revealed SA had more NCP compared to NSA (31% vs 22%, P<0.004). Among the SA subset, hypertension and family history of premature CAD were associated with higher mean TSS (2.12 vs 1.64 and 3.43 vs 2.42 respectively, P<0.05). In the NSA subset, male sex, dyslipidemia, diabetes mellitus , hypertension, higher body mass index were associated with higher mean TSS (4.12 vs 1.84, 3.66 vs 2.72, 4.81 vs 2.91, 4.14 vs 2.54, and 3.50 vs 2.31 respectively. P<0.01).
Conclusion: There was no significant difference in plaque burden between the two ethnic groups. More NCP was identified in SA compared to NSA. Risk factor association with plaque burden were different between the ethnic groups. Presence of higher degree of NCP could be among the reasons for higher rates of CAD morbidity and mortality in SA. CCTA may have the potential to enhance our understanding of CAD disease in SA.
- © 2013 by American Heart Association, Inc.