Peter R Villadsen1,2, Steffen E Petersen1, Damini Dey3, Lu Zou4, Shivali Patel1, Hafiz Naderi1, Katarzyna Gruszczynska1,5, Jan Baron5, L Ceri Davies1, Andrew Wragg1, Hans Erik Bøtker2, Francesca Pugliese1,2. 1. Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK. 2. Department of Cardiology, Arhus University Hospital, Arhus, Denmark. 3. Cedars-Sinai Medical Centre, Los Angeles, CA, USA. 4. Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UK. 5. Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland.
Abstract
AIMS: South Asian (SA) patients are known to have an increased incidence of acute cardiovascular events compared with Caucasians. The aim of this observational study was to compare the prevalence of coronary stenoses, the amount and composition of coronary atherosclerosis in a cohort of Caucasian and SA patients with stable chest pain, in non-acute settings. METHODS AND RESULTS: The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. In 963 consecutive Caucasian and SA patients undergoing coronary computed tomography angiography, atherosclerotic plaques were quantified using a semi-automated algorithm. The vessel per cent diameter and area stenosis were measured. Plaque composition was examined from the measurement of calcified, non-calcified, and total plaque burden. There were 420 Caucasian (238 males) and 543 SA (297 males) patients. Caucasian patients were older than SA patients (54.39 ± 11.65 vs. 49.83 ± 11.03 years) and had lower prevalence of diabetes (13.13 vs. 32.41%) and hyperlipidaemia (56.90 vs. 68.51%) (all P-values <0.001). After adjusting for differences in cardiovascular risk factors, there were no differences in per cent diameter and area stenosis, and no difference in the proportions of patients with one-, two-, or three-vessel disease. There was no difference in total plaque burden; however, the per cent non-calcified plaque composition was lower in Caucasians compared with SA (80.95 vs. 90.42%; P-value <0.001). CONCLUSION: This study conducted in non-acute settings showed an ethnic difference in composition of coronary atherosclerotic plaque with lower non-calcified composition in Caucasian patients compared with SA patients, which was independent of age, diabetes, hyperlipidaemia, and the other available cardiovascular risk factors. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: South Asian (SA) patients are known to have an increased incidence of acute cardiovascular events compared with Caucasians. The aim of this observational study was to compare the prevalence of coronary stenoses, the amount and composition of coronary atherosclerosis in a cohort of Caucasian and SA patients with stable chest pain, in non-acute settings. METHODS AND RESULTS: The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. In 963 consecutive Caucasian and SA patients undergoing coronary computed tomography angiography, atherosclerotic plaques were quantified using a semi-automated algorithm. The vessel per cent diameter and area stenosis were measured. Plaque composition was examined from the measurement of calcified, non-calcified, and total plaque burden. There were 420 Caucasian (238 males) and 543 SA (297 males) patients. Caucasian patients were older than SA patients (54.39 ± 11.65 vs. 49.83 ± 11.03 years) and had lower prevalence of diabetes (13.13 vs. 32.41%) and hyperlipidaemia (56.90 vs. 68.51%) (all P-values <0.001). After adjusting for differences in cardiovascular risk factors, there were no differences in per cent diameter and area stenosis, and no difference in the proportions of patients with one-, two-, or three-vessel disease. There was no difference in total plaque burden; however, the per cent non-calcified plaque composition was lower in Caucasians compared with SA (80.95 vs. 90.42%; P-value <0.001). CONCLUSION: This study conducted in non-acute settings showed an ethnic difference in composition of coronary atherosclerotic plaque with lower non-calcified composition in Caucasian patients compared with SA patients, which was independent of age, diabetes, hyperlipidaemia, and the other available cardiovascular risk factors. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Damini Dey; Victor Y Cheng; Piotr J Slomka; Ryo Nakazato; Amit Ramesh; Swaminatha Gurudevan; Guido Germano; Daniel S Berman Journal: J Cardiovasc Comput Tomogr Date: 2009-10-01
Authors: Benjamin J W Chow; Gary Small; Yeung Yam; Li Chen; Stephan Achenbach; Mouaz Al-Mallah; Daniel S Berman; Matthew J Budoff; Filippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Victor Cheng; Kavitha M Chinnaiyan; Augustin Delago; Allison Dunning; Martin Hadamitzky; Jörg Hausleiter; Philipp Kaufmann; Fay Lin; Erica Maffei; Gilbert L Raff; Leslee J Shaw; Todd C Villines; James K Min Journal: Circ Cardiovasc Imaging Date: 2011-07-05 Impact factor: 7.792
Authors: S S Anand; S Yusuf; V Vuksan; S Devanesen; K K Teo; P A Montague; L Kelemen; C Yi; E Lonn; H Gerstein; R A Hegele; M McQueen Journal: Lancet Date: 2000-07-22 Impact factor: 79.321