Ethnic differences in coronary plaque and epicardial fat volume quantified using computed tomography.
Epidemiological studies observed a higher prevalence of coronary atherosclerosis in South Asians when compared to Caucasians, but quantitative computed tomography differences in aggregate plaque volume (APV) and epicardial fat volume (EFV) between South Asians, Southeast or East Asians (SEEAs) and Caucasians remain unknown. We aimed to compare APV and EFV quantified on computed-tomographic-coronary-angiography (CTCA) between South Asian, SEEA and Caucasian populations residing in Australia. Age, gender and body-mass-index matched subjects from three ethnic groups who underwent clinically indicated 320-detector CTCA were retrospectively analysed. Percentage APV in the first 5 cm of the left anterior descending artery (LAD) and EFV were quantified using dedicated software (Vital Images, USA). One-hundred-and-fifty subjects (average age = 57.7 years, 56 % male, n = 50 in each ethnic group) were analysed. Mean LAD percentage APV was highest in South Asians (44.5 ± 8.4 % vs. 37.5 ± 6.5 % in SEEAs and 39.5 ± 6.4 % in Caucasians, P = 0.00001). South Asian ethnicity predicted LAD APV above traditional risk factors on multivariate analysis (P = 0.000002). EFV was significantly higher in both South Asians (103.2 ± 41.7 cm3vs. 85.8 ± 39.4 cm3, P = 0.035) and SEEAs (110.8 ± 36.9 cm3vs. 85.8 ± 39.4 cm3, P = 0.001) when compared with Caucasians. In this cohort LAD percentage APV and EFV, as quantified on CTCA, differs between South Asians, SEEA and Caucasian populations, with higher LAD APV observed in South Asians and lower EFV in Caucasians. Atherosclerotic volume in LAD was best predicted by South Asian ethnicity above traditional risk factors and EFV. Further research is required to establish whether APV and EFV quantification can improve cardiac risk prediction in the South Asian population.
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Daniel B
DB
Adams
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Om
O
Narayan
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Ravi Kiran
RK
Munnur
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
James D
JD
Cameron
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Dennis T L
DT
Wong
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Andrew H
AH
Talman
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Richard W
RW
Harper
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Sujith K
SK
Seneviratne
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia.
Ian T
IT
Meredith
Department of Medicine Monash Medical Centre (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, Melbourne, Australia. brianshiuhangko@gmail.com.
Brian S
BS
Ko
D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity / Q000208:ethnology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000208:ethnology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D010496:Pericardium / Q000000981:diagnostic imaging*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology; D044465:White People; D055815:Young Adult
Aggregate plaque volume; CT coronary angiography; Coronary artery disease; Epicardial fat; Ethnicity; South Asian
Diabetologia. 2006 Nov;49(11):2580-8
16972045
Clin Cardiol. 2011 Mar;34(3):166-71
21337349
J Epidemiol Community Health. 1990 Mar;44(1):24-8
2348144
Br J Radiol. 2016 Sep;89(1065):20160342
27351693
Lancet. 2000 Jul 22;356(9226):279-84
11071182
Glob Heart. 2014 Mar;9(1):59-64
25432114
PLoS One. 2015 Apr 17;10 (4):e0123317
25884221
J Am Coll Cardiol. 2007 Sep 18;50(12 ):1161-70
17868808
Glob Heart. 2014 Mar;9(1):53-8
25432113
Int J Cardiol. 2013 Oct 15;168(6):5422-9
24035066
Circulation. 2002 Jan 29;105(4):539-42
11815441
Circulation. 2008 Feb 12;117(6):743-53
18212285
Int J Cardiovasc Imaging. 2016 Feb;32(2):317-28
26335371
Int J Cardiol. 2013 Sep 10;167(6):2472-6
22704877
Circ J. 2008 Aug;72 (8):1276-81
18654013
Glob Heart. 2014 Mar;9(1):91-9
24977114
Lancet. 2012 Dec 15;380(9859):2197-223
23245608
Circulation. 2005 Mar 15;111(10):1313-20
15769774
Angiology. 2008 Aug-Sep;59(4):442-7
18388092
Int J Cardiol. 2008 Oct 13;129(3):406-13
18022712
Atherosclerosis. 2010 May;210(1):150-4
20031133
PLoS Med. 2006 Nov;3(11):e442
17132052
CMAJ. 2010 May 18;182(8):E301-10
20403888
Atherosclerosis. 2012 Jan;220(1):223-30
22015177
J Am Coll Cardiol. 2007 Jan 2;49(1):62-70
17207724
Obesity (Silver Spring). 2010 Nov;18(11):2177-83
20448537
Ann Epidemiol. 2011 Aug;21(8):608-14
21737048
Am J Cardiol. 2014 Jun 1;113(11):1782-7
24746030
J Am Coll Cardiol. 2008 Nov 18;52(21):1724-32
19007693
Int J Obes (Lond). 2015 Mar;39(3):488-94
25109783
J Cardiovasc Comput Tomogr. 2009 Mar-Apr;3(2):122-36
19272853