Aggressive and diffuse coronary calcification in South Asian angina patients compared to Caucasians with similar risk factors

Koulaouzidis, George; Nicoll, Rachel; Charisopoulou, Dafni; McArthur, T.; Jenkins, P; Henein, Michael Y.

doi:10.1016/j.ijcard.2012.05.102

Cited by 32 publications

(14 citation statements)

References 33 publications

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“…In a study of angina patients, South Asians had similar conventional risk factors but more aggressive and diffuse arterial calcification with higher CAC scores and diffuse plaque burden compared to Europeans. 23 In a case control study of heart disease patients, South Asian men had similar CAC scores compared to European men, but a greater coronary artery stenosis overall. 24 In addition, some angiography studies have found that South Asians have more proximal distribution and longer lesions of coronary artery disease 25 and smaller coronary artery diameter than Europeans.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have investigated patterns of coronary calcification among South Asian patients with angina 23 and heart disease, 24 with somewhat disparate results. In a study of angina patients, South Asians had similar conventional risk factors but more aggressive and diffuse arterial calcification with higher CAC scores and diffuse plaque burden compared to Europeans.…”

Section: Discussionmentioning

confidence: 99%

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Comparing coronary artery calcium among U.S. South Asians with four racial/ethnic groups: The MASALA and MESA studies

et al. 2014

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Objectives South Asians (individuals from India, Pakistan, Bangladesh, Nepal, and Sri Lanka) have high rates of cardiovascular disease which cannot be explained by traditional risk factors. Few studies have examined coronary artery calcium (CAC) in South Asians. Methods We created a community-based cohort of South Asians in the United States and compared the prevalence and distribution of CAC to four racial/ethnic groups in the Multi-Ethnic Study of Atherosclerosis (MESA). We compared 803 asymptomatic South Asians free of cardiovascular disease to the four MESA racial/ethnic groups (2,622 Whites, 1,893 African Americans, 1,496 Latinos and 803 Chinese Americans). Results The age-adjusted prevalence of any CAC was similar between White and South Asian men, but was lower in South Asian women compared to White women. After adjusting for all covariates associated with CAC, South Asian men were similar to White men and had higher CAC scores compared to African Americans, Latinos and Chinese Americans. In fully adjusted models, CAC scores were similar for South Asian women compared to all women enrolled in MESA. However, South Asian women ≥70 years had a higher prevalence of any CAC than most other racial/ethnic groups. Conclusions South Asian men have similarly high CAC burden as White men, but higher CAC than other racial/ethnic groups. South Asian women appear to have similar CAC burden compared to other women, but have somewhat higher CAC burden in older age. The high burden of subclinical coronary atherosclerosis in South Asians may partly explain higher rates of cardiovascular disease in South Asians.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing coronary artery calcium among U.S. South Asians with four racial/ethnic groups: The MASALA and MESA studies

et al. 2014

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“…on the prevalence of cardiac risk factors. The prevalence of traditional cardiovascular risk factors is high in some populations such as Surinamese, 38,39 Finnish, 15 Turkish, 40 Arab, 41 and South Asian, 42,43 and these groups were found to be at greater cardiovascular risk in the studies included in this review, and populations with lower cardiovascular incidence also generally had a lower prevalence of risk factors. 44,45 The previously noted North West to South East gradient in Europe in cardiovascular risk 46,47 was also observed here, with Eastern Europeans generally having a greater likelihood of experiencing both IHD and stroke.…”

Section: Discussionmentioning

confidence: 89%

The Risk of Ischemic Heart Disease and Stroke Among Immigrant Populations: A Systematic Review

Sohail

Chu

Rezai

et al. 2015

Canadian Journal of Cardiology

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“…Additionally, in a study that used CTCA and CAC to compare symptomatic South Asians and Caucasians with similar risk factors, it was observed that in patients aged ≥50 years, South Asians had a greater mean number of arterial segments with both obstructive and non obstructive plaque, and higher CAC scores. Interestingly, in patients ≤50 years, Caucasians showed a higher mean number of diseased segments with non obstructive plaques with similar CAC scores suggesting that Caucasians are likely to have more diffuse atherosclerosis at an earlier age although South Asians had higher prevalence and severity of disease (69).…”

Section: Ethnicitymentioning

confidence: 96%

Imaging of coronary atherosclerosis in various susceptible groups

Munnur

Nerlekar

Wong

2016

Cardiovasc. Diagn. Ther.

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Coronary artery disease (CAD) is the leading cause of death and disability worldwide. Atherosclerosis, which is the primary pathophysiologic mechanism for the development of plaque leading to CAD, is a multifactorial process resulting from a complex interplay between genetic susceptibility and various risk factors such as hypertension (HT), dyslipidaemia, diabetes mellitus (DM) and smoking. In addition, influences from other disease states such as chronic kidney disease (CKD), obesity and the metabolic syndrome as well as gender and ethnic diversity also contribute to the disease process. Insights from pathological observations and advances in cellular and molecular biology have helped us understand the process of plaque formation, progression and rupture leading to events. Several intravascular imaging techniques such as intravascular ultrasound (IVUS), Virtual histology IVUS (VH-IVUS) and optical coherence tomography (OCT) allow in vivo assessment of plaque burden, plaque morphology and response to therapy. In addition, non invasive assessment using coronary artery calcium (CAC) score allows risk stratification and plaque burden assessment whilst computed tomography coronary angiography (CTCA) allows evaluation of luminal stenosis, plaque characterisation and quantification. This review aims to summarise the results of invasive and non-invasive imaging studies of coronary atherosclerosis seen in various high-risk populations including DM, metabolic syndrome, obesity, CKD and, gender differences and ethnicity. Understanding the phenotype of plaques in various susceptible groups may allow potential development of personalised therapies.

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Aggressive and diffuse coronary calcification in South Asian angina patients compared to Caucasians with similar risk factors

Cited by 32 publications

References 33 publications

Comparing coronary artery calcium among U.S. South Asians with four racial/ethnic groups: The MASALA and MESA studies

Comparing coronary artery calcium among U.S. South Asians with four racial/ethnic groups: The MASALA and MESA studies

The Risk of Ischemic Heart Disease and Stroke Among Immigrant Populations: A Systematic Review

Imaging of coronary atherosclerosis in various susceptible groups

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