title: Coronary atherosclerotic plaque burden and composition by CT angiography in Caucasian and South Asian patients with stable chest pain.
abstract: OBJECTIVE
  South Asian (SA) patients are known to have an increased incidence of acute cardiovascular events compared with Caucasians. The aim of this observational study was to compare the prevalence of coronary stenoses, the amount and composition of coronary atherosclerosis in a cohort of Caucasian and SA patients with stable chest pain, in non-acute settings.
  
  
  RESULTS
  The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. In 963 consecutive Caucasian and SA patients undergoing coronary computed tomography angiography, atherosclerotic plaques were quantified using a semi-automated algorithm. The vessel per cent diameter and area stenosis were measured. Plaque composition was examined from the measurement of calcified, non-calcified, and total plaque burden. There were 420 Caucasian (238 males) and 543 SA (297 males) patients. Caucasian patients were older than SA patients (54.39 ± 11.65 vs. 49.83 ± 11.03 years) and had lower prevalence of diabetes (13.13 vs. 32.41%) and hyperlipidaemia (56.90 vs. 68.51%) (all P-values <0.001). After adjusting for differences in cardiovascular risk factors, there were no differences in per cent diameter and area stenosis, and no difference in the proportions of patients with one-, two-, or three-vessel disease. There was no difference in total plaque burden; however, the per cent non-calcified plaque composition was lower in Caucasians compared with SA (80.95 vs. 90.42%; P-value <0.001).
  
  
  CONCLUSIONS
  This study conducted in non-acute settings showed an ethnic difference in composition of coronary atherosclerotic plaque with lower non-calcified composition in Caucasian patients compared with SA patients, which was independent of age, diabetes, hyperlipidaemia, and the other available cardiovascular risk factors.
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.|Department of Cardiology, Arhus University Hospital, Arhus, Denmark.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Villadsen
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.
authors.forename: Steffen E
authors.initials: SE
authors.lastname: Petersen
authors.affiliation: Cedars-Sinai Medical Centre, Los Angeles, CA, USA.
authors.forename: Damini
authors.initials: D
authors.lastname: Dey
authors.affiliation: Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UK.
authors.forename: Lu
authors.initials: L
authors.lastname: Zou
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.
authors.forename: Shivali
authors.initials: S
authors.lastname: Patel
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.
authors.forename: Hafiz
authors.initials: H
authors.lastname: Naderi
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.|Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gruszczynska
authors.affiliation: Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Baron
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.
authors.forename: L Ceri
authors.initials: LC
authors.lastname: Davies
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wragg
authors.affiliation: Department of Cardiology, Arhus University Hospital, Arhus, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: Centre for Advanced Cardiovascular Imaging, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London and St Bartholomew's Hospital, 2nd floor, King George V Building, West Smithfield, London EC1A 7BE, UK.|Department of Cardiology, Arhus University Hospital, Arhus, Denmark.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pugliese
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging / Q000208:ethnology*; D044466:Asian People / Q000706:statistics & numerical data*; D015331:Cohort Studies; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000208:ethnology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000208:ethnology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D044465:White People / Q000706:statistics & numerical data*
keywords: atherosclerosis; computed tomography; computed tomography angiography; coronary artery disease; coronary circulation; ethnicity