USA: Calcium specks in walls of the coronary artery could be a prognostic marker for early detection of cardiovascular disease (CVD) in South Asians, finds a new study. This may help guide treatment of CVD in this population.
The study, published in the journal Journal of the American Heart Association, finds that South Asian men had greater coronary artery calcium (CAC) change than Chinese, black, and Latino men but similar change to that of whites after adjusting for traditional risk factors.
South Asians are known to have a high chance of developing CVD and represent more than 60 percent of CVD patients worldwide. They also develop risk factors such as high blood pressure, cholesterol, and diabetes at a younger age than other racial and ethnic groups. However, it remains unclear which clinical factors could help determine those at highest risk.
The study is among the findings being generated by the ongoing Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. MASALA is the first long-term study in this population that aims to better understand the factors leading to heart disease and guide prevention and treatment.
Alka M. Kanaya, University of California, San Francisco, San Francisco, USA, and colleagues, determined CAC incidence and progression among South Asians and compared them with 4 race/ethnic groups.
In the present study of nearly 700 patients with ethnic backgrounds from India, Pakistan, Bangladesh, Sri Lanka, Nepal and Bhutan, UCSF researchers found that South Asian men had the same high rates of change in calcification of their artery walls over a five-year period as white men, the group with the highest rates of cardiovascular disease.
The researchers measured calcification in 698 MASALA patients from CT scans taken five years apart. They compared the incidence and progression rates of CAC to other populations using data from the Multi-Ethnic Study of Atherosclerosis (MESA), a study similar to MASALA that is investigating potential factors for early atherosclerosis in more than 6,800 diverse participants from six U.S. cities.
Early signs of coronary artery calcification (CAC), in which calcium specks appear in artery walls, can be detected through a computed tomography (CT) scan. In other ethnic groups, high CAC scores have been proven to be an early sign of those at high risk of developing cardiovascular disease.
The American Heart Association recently recommended CAC testing in individuals with intermediate heart disease risk to help determine whether they should be treated with cholesterol-lowering medications. These guidelines classify South Asians as a high-risk group.
- South Asian men had a higher rate of new calcification than South Asian women, 8.8 percent to 3.6 percent, respectively.
- After accounting for differences in age, diabetes, high blood pressure and statin use, increases in CAC were similar in South Asian men compared to white men but 122 percent, 64 percent and 54 percent larger than the increases in African Americans, Latinos, and Chinese Americans, respectively.
- There was no significant difference in the amount of CAC change among women in different race/ethnic groups.
“Both CAC burden and progression have been shown to be independent predictors of coronary heart disease in whites, blacks, Latinos and Chinese Americans,” Kanaya said. “The next step for us is to determine if CAC burden and/or progression predicts those at highest risk of having a heart attack or stroke among South Asians.”
For further reference follow the link: https://doi.org/10.1161/JAHA.118.011053