Impact of south asian ethnicity on total plaque volume, calcified plaque volume and non-calcified plaque volume in the coronary arteries: a coronary CT angiography study in East London (UK)

Abstract

Purpose: The impact of ethnicity on coronary heart disease has received scarce attention. The purpose of this study was to compare the extent and composition of coronary atherosclerosis in South Asian and Caucasian patients with stable chest pain. Methods: Between March 2010 and January 2012 we included 1159 consecutive patients in East London who underwent coronary CT angiography for stable chest pain. The prevalence of diabetes, hypercholesterolemia, hypertension, smoking and family history was obtained. CT angiography was performed using a 128-slice dual-source scanner. For patients with good or excellent image quality atherosclerotic plaques were quantified using an automated algorithm estimating calcified (CPV), non-calcified (NCPV) and total plaque volume (TPV). Severity and extent of atherosclerotic lesions were assessed using degree of vessel disease and segment involvement score. The groups were compared using univariate and multivariate regression analysis. Results: Image quality was good or excellent in 974/1159 (84%) patients. Of these, 550 were SA and 424 were Caucasians. SA patients were younger (50±11 vs. 54±12 years), had higher prevalence of diabetes mellitus (39% vs. 16%), hyperlipidemia (75% vs. 63%), but lower smoking prevalence (37% vs. 59%). After adjustment for confounders, Caucasians had a 1.3-fold [95% CI: 1.1-1.6] higher CPV compared to SA. Ethnicity was not independently associated with NCPV or TPV. Age, gender, diabetes mellitus and hypertension were independently associated with CPV, NCPV and TPV, smoking and hyperlipidemia only with TPV and NCPV. Ethnicity did not predict severity or extent of atherosclerotic lesions. Conclusion: For patients with stable coronary heart disease South Asians had significantly less calcified disease than Caucasians. No difference was observed between the groups for non-calcified and total plaque volume or severity and extent of disease.