OBJECTIVES: The purpose of this study was to evaluate the prognostic value of coronary artery calcium (CAC), a known marker of subclinical atherosclerosis, in a large, ethnically diverse cohort of 14,812 patients for the prediction of all-cause mortality. BACKGROUND: Disparities in case fatality rates for heart disease among ethnic groups are well known. In 2001, rates of death from heart disease were 30% higher among African Americans (AA) than non-Hispanic whites (NHW). Some of this variability may be due to differing pathophysiological mechanisms and effects of underlying atherosclerosis. METHODS: Ten-year death rates from all causes (total deaths = 505) were compared using risk-adjusted Cox proportional hazards models in AA (n = 637), Hispanic (HS, n = 1,334), Asian (AS, n = 1,065), and NHW (n = 11,776) populations. RESULTS: Ethnic minority patients were generally younger (0.3 to 4 years), more often persons with diabetes (p < 0.0001), hypertensive (p < 0.0001), and female (p < 0.0001). The prevalence of CAC scores > or =100 was highest in NHW (31%) and lowest for HS (18%) (p < 0.0001). Overall survival was 96%, 93%, and 92% for AS, NHW, and HS, respectively, as compared with 83% for AA (p < 0.0001). When comparing prognosis by CAC scores in ethnic minorities as compared with NHW, relative risk ratios were highest for AA with CAC scores > or =400 exceeding 16.1 (p < 0.0001). Hispanics with CAC scores > or =400 had relative risk ratios from 7.9 to 9.0, whereas AS with CAC scores > or =1,000 had relative risk ratios 6.6-fold higher than NHW (p < 0.0001). CONCLUSIONS: Consistent with population evidence, AA with increasing burden of subclinical coronary artery disease were the highest-risk ethnic minority population. These data support a growing body of evidence noting substantial differences in cardiovascular risk by ethnicity.
OBJECTIVES: The purpose of this study was to evaluate the prognostic value of coronary artery calcium (CAC), a known marker of subclinical atherosclerosis, in a large, ethnically diverse cohort of 14,812 patients for the prediction of all-cause mortality. BACKGROUND: Disparities in case fatality rates for heart disease among ethnic groups are well known. In 2001, rates of death from heart disease were 30% higher among African Americans (AA) than non-Hispanic whites (NHW). Some of this variability may be due to differing pathophysiological mechanisms and effects of underlying atherosclerosis. METHODS: Ten-year death rates from all causes (total deaths = 505) were compared using risk-adjusted Cox proportional hazards models in AA (n = 637), Hispanic (HS, n = 1,334), Asian (AS, n = 1,065), and NHW (n = 11,776) populations. RESULTS: Ethnic minority patients were generally younger (0.3 to 4 years), more often persons with diabetes (p < 0.0001), hypertensive (p < 0.0001), and female (p < 0.0001). The prevalence of CAC scores > or =100 was highest in NHW (31%) and lowest for HS (18%) (p < 0.0001). Overall survival was 96%, 93%, and 92% for AS, NHW, and HS, respectively, as compared with 83% for AA (p < 0.0001). When comparing prognosis by CAC scores in ethnic minorities as compared with NHW, relative risk ratios were highest for AA with CAC scores > or =400 exceeding 16.1 (p < 0.0001). Hispanics with CAC scores > or =400 had relative risk ratios from 7.9 to 9.0, whereas AS with CAC scores > or =1,000 had relative risk ratios 6.6-fold higher than NHW (p < 0.0001). CONCLUSIONS: Consistent with population evidence, AA with increasing burden of subclinical coronary artery disease were the highest-risk ethnic minority population. These data support a growing body of evidence noting substantial differences in cardiovascular risk by ethnicity.
Authors: Akira Sekikawa; Chol Shin; J David Curb; Emma Barinas-Mitchell; Kamal Masaki; Aiman El-Saed; Todd B Seto; Rachel H Mackey; Jina Choo; Akira Fujiyoshi; Katsuyuki Miura; Daniel Edmundowicz; Lewis H Kuller; Hirotsugu Ueshima; Kim Sutton-Tyrrell Journal: Atherosclerosis Date: 2012-03-27 Impact factor: 5.162
Authors: Matthijs Oudkerk; Arthur E Stillman; Sandra S Halliburton; Willi A Kalender; Stefan Möhlenkamp; Cynthia H McCollough; Rozemarijn Vliegenthart; Leslee J Shaw; William Stanford; Allen J Taylor; Peter M A van Ooijen; Lewis Wexler; Paolo Raggi Journal: Eur Radiol Date: 2008-07-24 Impact factor: 5.315
Authors: Vanessa Xanthakis; Jung Hye Sung; Tandaw E Samdarshi; Alethea N Hill; Solomon K Musani; Mario Sims; Kamel A Ghraibeh; Philip R Liebson; Herman A Taylor; Ramachandran S Vasan; Ervin R Fox Journal: Diabetes Care Date: 2015-03-12 Impact factor: 19.112
Authors: C Noel Bairey Merz; Mark J Alberts; Gary J Balady; Christie M Ballantyne; Kathy Berra; Henry R Black; Roger S Blumenthal; Michael H Davidson; Sara B Fazio; Keith C Ferdinand; Lawrence J Fine; Vivian Fonseca; Barry A Franklin; Patrick E McBride; George A Mensah; Geno J Merli; Patrick T O'Gara; Paul D Thompson; James A Underberg Journal: J Am Coll Cardiol Date: 2009-09-29 Impact factor: 24.094
Authors: Bryan R Kestenbaum; Kathryn L Adeney; Ian H de Boer; Joachim H Ix; Michael G Shlipak; David S Siscovick Journal: Kidney Int Date: 2009-08-19 Impact factor: 10.612