Abstract 17316: Inflammation and Coronary Artery Calcification in South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study
Introduction: Inflammatory biomarkers and adipocytokines (IBA) may contribute to atherosclerosis by promoting vascular inflammation, which is associated with increased CHD risk in some ethnic groups. The association between markers of inflammation and coronary artery calcium (CAC), a marker of subclinical atherosclerosis and a predictor of incident CHD, is not well defined in South Asians (SA).
Hypothesis: IBAs [high sensitivity C-reactive protein (hsCRP), tumor necrosis factor alpha (TNF-α), adiponectin, and leptin] are independently associated with and improve discrimination of CAC when added to traditional risk factors.
Methods: We used baseline data from 906 MASALA participants. Logistic regression models were used to examine the cross-sectional association of IBAs with CAC presence (>0) and severity (>100). IBAs were categorized as the upper tertile vs. the lower two (hsCRP, TNF- α, leptin) and lower vs. upper two (adiponectin). The C-statistic assessed the incremental contribution of each marker to elements of the pooled cohort equation for the discrimination of CAC.
Results: Overall, SA women had significantly higher levels of hsCRP, adiponectin and leptin than men (Table). There was no significant association between any marker and CAC >0 or >100 in adjusted models. Lower adiponectin was associated with lower CAC prevalence in women [0.32 (0.13-0.81)], but not in men (p for interaction = 0.01). In a sensitivity analysis excluding 243 statin users, leptin was inversely associated with CAC>100, OR 0.45 (95% CI: 0.20, 0.95). None of the markers significantly improved discrimination of CAC.
Conclusion: There was no association between inflammatory biomarkers/adipocytokines and CAC after adjustment for traditional risk factors in the overall SA population. Contrary to expectations, higher adiponectin levels were associated with CAC>0 in women. CAC may have a distinct pathophysiology not dependent on adiposity-related inflammation in South Asians.
Author Disclosures: J. Patel: None. M. Al Rifai: None. C. Ayers: None. I.J. Neeland: None. A.M. Kanaya: None. N. Kandula: None. M.J. Blaha: None. K. Nasir: None. R.S. Blumenthal: None. P.H. Joshi: None.
- © 2016 by American Heart Association, Inc.