Distribution of Calcium Volume, Density, Number, and Type of Coronary Vessel With Calcified Plaque in South Asians in the US and Other Race/Ethnic Groups: The MASALA and MESA Studies

Authors

Mahmoud Al Rifai
Alka M Kanaya
Namratha R Kandula
Miguel Cainzos-Achirica
Jaideep Patel
Matthew Budoff
Michael H Criqui
Michael J Blaha
Salim S Virani

Publication Date

1-1-2021

Journal

Atherosclerosis

DOI

10.1016/j.atherosclerosis.2020.12.003

PMID

33333344

PMCID

PMC7790973

PubMedCentral® Posted Date

1-1-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Asian, Atherosclerosis, Calcium, Coronary Artery Disease, Coronary Vessels, Female, Humans, Male, Middle Aged, Plaque, Atherosclerotic, Prevalence, Risk Factors

Abstract

BACKGROUND AND AIMS: South Asians (SA) experience disproportionately higher rates of atherosclerotic cardiovascular disease (ASCVD) events than non-Hispanic whites (NHW) and several other Asian groups. The coronary artery calcium (CAC) Agatston score may not capture the unique characteristics of coronary plaque in SA. We therefore evaluated the prevalence and patterns of advanced CAC measures (specific coronary vessel involvement, CAC volume and density) in SA versus other race/ethnicities.

METHODS: We combined data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and Multi-Ethnic Study of Atherosclerosis (MESA) cohorts. We used multivariable-adjusted linear regression models to compare advanced CAC measures between SA and other ethnicities.

RESULTS: Our analyses included 7,625 individuals (810 SA, 2,622 whites, 1,893 African Americans, 1,496 Hispanics, 803 Chinese Americans) with mean (SD) age 62 (10) years and 48% men. In adjusted analyses, compared to NHW, SA had lower overall CAC volume [beta coefficient (95% CI)] [-0.46 (-0.62,-0.29)] but higher overall CAC density [0.14 (0.11,0.18)]. These trends were similar when SA were compared to non-whites (Hispanics, Chinese Americans, and African Americans). SA had higher overall [0.07 (0.03,0.12)] and right coronary artery [0.09 (0.03,0.16)] CAC density compared to non-whites, while CAC volume was not significantly different between these two groups.

CONCLUSIONS: SA have lower CAC volume compared to NHW but similar compared to non-whites. Overall CAC density is higher among SA compared to NHW and non-whites. Future longitudinal studies of ASCVD events are required to confirm the prognostic significance of these findings among SA.

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