Racial differences in coronary calcium prevalence among high-risk adults.
A total of 1,461 asymptomatic high-risk adult subjects were studied with digital subtraction fluoroscopy and conventional cinefluoroscopy to detect coronary calcium. Ethnicity and risk factor data were recorded. No subject had a history or electrocardiographic evidence of prior myocardial infarction. The prevalence of coronary calcium by digital subtraction fluoroscopy was high (58%). Substantial ethnic differences in prevalence were noted: 36% of African American subjects, 60% of Caucasian subjects, and 60% of Asian American subjects had definite radiographic evidence of coronary calcium. The difference in prevalence between African American and other subjects was significant (p < 0.0001) by chi-square test for all 3 races. These differences persisted in the unsubtracted cinefluoroscopic images (p < 0.0001) and after controlling for age, gender, and other risk factors (p = 0.003). After 20 +/- 11 months of follow-up, African Americans had more coronary artery disease events (13%) than Caucasians (6%) or Asian Americans (5%) (p = 0.04). Thus, African Americans have a significantly lower prevalence of coronary calcium than do Caucasians or Asian Americans. Based on the follow-up results, these differences in prevalence are not explained by differences in coronary artery disease risk.
Tang
W
W
Saint John's Cardiovascular Research Center, Torrance, California, USA.
Detrano
R C
RC
Brezden
O S
OS
Georgiou
D
D
French
W J
WJ
Wong
N D
ND
Doherty
T M
TM
Brundage
B H
BH
D000368:Aged; D000704:Analysis of Variance; D044466:Asian People; D044383:Black People; D002118:Calcium / Q000378:metabolism*; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000378:metabolism; D003331:Coronary Vessels / Q000378:metabolism*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D044469:Racial Groups; D011856:Radiographic Image Enhancement; D012307:Risk Factors; D044465:White People; D001741:Black or African American
D002118:Calcium