Ethnic differences in coronary atherosclerosis.
OBJECTIVE
The study was done to evaluate whether ethnic differences exist in the prevalence of coronary artery calcification (CAC), and to determine whether differences in calcification correlate with the degree of coronary obstruction.


BACKGROUND
Electron beam tomography (EBT) can be used to quantitate the amount of CAC and assist in prognostication of future cardiac events. It is unclear whether ethnic differences in coronary mortality are related to differences in the prevalence of coronary obstruction and CAC.


METHODS
A total of 782 symptomatic subjects underwent both EBT and angiography. A 50% luminal narrowing defined an angiographic obstruction.


RESULTS
We observed substantial ethnic differences in prevalence of both CAC and angiographic stenosis. In whites (n = 453), prevalence of CAC (score >0) was 84%, and significant obstruction on angiogram was 71%. Compared with whites, blacks (n = 108) had a significantly lower prevalence of CAC (62%, p < 0.001) and angiographic disease (49%, p < 0.01). Hispanics (n = 177) also had a lower prevalence of CAC (71%, p < 0.001) and angiographic obstruction (58%, p < 0.01). Asians (n = 44) were not significantly different in regard to CAC (73%, p = 0.06) or angiographic stenosis (64%, p = 0.30). These ethnic differences remained after simultaneously controlling (by use of multiple logistic regression) for age, gender and cardiac risk factors.


CONCLUSIONS
As compared with whites, blacks and Hispanics had significantly lower prevalence of CAC and obstructive coronary disease. Ethnic differences in risk-factor profiles do not explain these differences. This study demonstrated that whites have a higher atherosclerotic burden than blacks and Hispanics, independent of risk-factor differences among symptomatic patients referred for angiography.
Budoff
Matthew J
MJ
Division of Cardiology, Department of Medicine, Harbor-UCLA Medical Center, Torrance, California 90502-2064, USA. mbudoff@rei.edu
Yang
Ted P
TP
Shavelle
Robert M
RM
Lamont
Daniel H
DH
Brundage
Bruce H
BH
D000328:Adult; D000368:Aged; D044466:Asian People; D044383:Black People; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D044465:White People