Abstract 163: Association of Diabetes With Coronary Artery Calcium in South Asians, African Americans, Caucasians, Chinese, and Hispanics: The Multi-Ethnic Study of Atherosclerosis (MESA) and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ned Premyodhin ◽  
Wenjun Fan ◽  
Millie Arora ◽  
Masood Younus ◽  
Matthew J Budoff ◽  
...  
Keyword(s):  
Coronary Artery ◽  
African Americans ◽  
Ethnic Groups ◽  
Coronary Artery Calcium ◽  
South Asians ◽  
Subclinical Atherosclerosis ◽  
Study Cohort ◽  
Atherosclerotic Cardiovascular Disease ◽  
Normal Glucose

Introduction: South Asians (SA) have increased atherosclerotic cardiovascular disease (ASCVD) risk and SA ethnicity is considered a “risk-enhancing factor” in the latest prevention guidelines. Diabetes mellitus (DM) is common in SA, but it is not known how pre-DM or DM may contribute to subclinical atherosclerosis in SA compared to other ethnic groups. We examined the association of pre-DM and DM to coronary artery calcium (CAC) in SA compared to 4 other ethnic groups. Methods: We studied data from SA, African Americans (AA), non-Hispanic whites (NHW), Chinese (CH), and Hispanics (HS) aged 45-84 without known ASCVD. SA were taken exclusively from MASALA and other groups from MESA. The prevalence of CAC 0, 1-99, 100-399, and 400+ were examined among those who were normoglycemic, pre-DM and DM. Multiple logistic regression adjusted for age, sex, smoking, cholesterol, and blood pressure identified the associations of pre-DM and DM (compared to normal glucose) on the odds of any CAC > 0 and significant CAC ≥ 100 by ethnicity. Results: Of the 7587 included individuals, mean age was 62±10 years, with 48% men, 10% SA, 25% AA, 34% NHW, 11% CH and 20% HS. The prevalence of pre-DM and DM varied significantly (p < 0.01) across ethnic groups: SA (25% and 21%), AA (15% and 18%), NHW (11% and 6%), CH (17% and 13%) and HS (15% and 17%). The prevalence of any CAC and CAC ≥ 100 in those with DM were highest in NHW (80% and 48%) and SA (72% and 41%). Pre-DM was only associated with CAC ≥ 100 in NHW (OR = 1.5, p < 0.01). Compared to other groups, SA with DM (compared to those normoglycemic) had the highest odds ratios (ORs) for CAC > 0 (OR = 3.35, p < 0.01) and CAC ≥ 100 (OR = 3.10, p < 0.01) (p = 0.01 and 0.07 for ethnicity interactions, respectively) (Table). Conclusions: Diabetes was associated with higher odds of any or significant CAC among SA compared to other ethnic groups. Ongoing longitudinal follow-up of the MASALA study cohort might help explain if DM contributes to the often premature ASCVD outcomes in SA.

Abstract MP079: Coronary Artery Calcium Incidence and Progression Among South Asians: Results From the MASALA Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Alka M Kanaya ◽  
Namratha Kandula ◽  
David Herrington ◽  
Kiang Liu ◽  
Matthew Budoff
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Ethnic Groups ◽  
South Asian ◽  
Coronary Artery Calcium ◽  
South Asians ◽  
Agatston Score ◽  
Visceral Fat Area ◽  
Asian Men

Background: South Asians have a high burden of cardiovascular disease. We have reported that South Asians have similarly high prevalence of coronary artery calcium (CAC) compared to non-Hispanic Whites, and higher CAC than other U.S. ethnic minority groups. No studies have determined the incidence or progression of CAC among South Asians. Methods: We used data from a community-based cohort of South Asians (MASALA) and calculated change in CAC Agatston score between Exam 1 (2010-2013) and Exam 2 (2015-2016) among 379 South Asians. We calculated the average annual incident CAC for those with no CAC at Exam 1, and CAC progression among those with CAC at Exam 1. We compared these findings to the previously reported CAC incidence and progression in the Multi-Ethnic Study of Atherosclerosis (MESA). We also determined factors associated with a ≥100 change in CAC score. Results: We used data from 240 men and 139 women with repeat CAC measured after 4.5±0.7 years of follow-up. Among those with no detectable CAC at baseline, 6.8% developed incident CAC annually (9.2% of men and 4.4% of women), which was similar to MESA race/ethnic groups. Among those with known CAC at baseline, the median annual CAC progression was 23 (interquartile range, 8-56). The table shows the distribution of annual CAC progression. South Asians overall, but particularly South Asian men, had significantly higher annual CAC progression compared to the reported average in MESA (overall median 18, 4-53). Established risk factors (age, male sex, diabetes and hypertension), pericardial fat volume and visceral fat area were associated with greater CAC progression. Conclusions: These preliminary results suggest that South Asian men have significantly greater CAC progression compared to other race/ethnic groups. Longer follow-up of MASALA will determine whether CAC score or CAC progression are important predictors of cardiovascular disease events.

scholarly journals Comparing coronary artery calcium among U.S. South Asians with four racial/ethnic groups: The MASALA and MESA studies

2014 ◽  
Vol 234 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Alka M. Kanaya ◽  
Namratha R. Kandula ◽  
Susan K. Ewing ◽  
David Herrington ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ethnic Groups ◽  
Coronary Artery Calcium ◽  
South Asians ◽  
Racial Ethnic

scholarly journals Incidence and Progression of Coronary Artery Calcium in South Asians Compared With 4 Race/Ethnic Groups

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Alka M. Kanaya ◽  
Eric Vittinghoff ◽  
Feng Lin ◽  
Namratha R. Kandula ◽  
David Herrington ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ethnic Groups ◽  
Coronary Artery Calcium ◽  
South Asians

Abstract P319: Comparing Coronary Artery Calcium among U.S. South Asians with Four Racial/Ethnic Groups: The MASALA and MESA Studies

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Alka M Kanaya ◽  
Namratha R Kandula ◽  
David Herrington ◽  
Kiang Liu ◽  
Michael J Blaha ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ethnic Groups ◽  
South Asian ◽  
Coronary Artery Calcium ◽  
South Asians ◽  
Chinese Americans ◽  
Asian Women ◽  
South Asian Women ◽  
Asian Men ◽  
Racial Ethnic

Background: South Asians (individuals from India, Pakistan, Bangladesh, Nepal, and Sri Lanka) have high rates of cardiovascular disease (CVD) which cannot be fully explained by traditional risk factors. We created a community-based cohort of South Asians (MASALA) and compared the prevalence of coronary artery calcium (CAC) to four racial/ethnic groups in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We compared 803 South Asians to the four racial/ethnic groups (2,622 Whites, 1,893 African Americans, 1,496 Latinos and 803 Chinese Americans), all free of CVD. We created pooled multivariate Poisson models to examine the effect of race/ethnicity with CAC after adjusting for sex, age, clinical site, education, smoking, BMI, diabetes, hypertension, HDL-, LDL-cholesterol, and cholesterol lowering medication use. Results: The age-adjusted prevalence of any CAC was similar between White and South Asian men (68%), but was lower in Latino (58%), Chinese American (58%) and African American men (51%). South Asian women had similar CAC prevalence as other ethnic minority women but significantly lower than White women (37% vs. 43%, p<0.05). The figure shows the mean CAC scores among each of the five racial/ethnic groups by 5-year increments in age. After adjusting for all covariates, South Asian men were similar to White men and had higher CAC scores compared to African Americans, Latinos and Chinese Americans. In fully adjusted models, CAC scores were similar for South Asian women compared to all MESA groups. However, South Asian women ≥70 years had a higher prevalence of any CAC than all other racial/ethnic groups. Conclusions: South Asian men are more similar to Whites than the other race/ethnic groups in MESA. The high burden of subclinical atherosclerosis in South Asians may partly explain higher rates of CVD in South Asians. Follow-up data from the MASALA study will determine whether CAC is associated with incident CVD among South Asians and if this relationship differs from that observed in other racial/ethnic groups.

scholarly journals Sex differences in coronary artery calcium progression: The Korea Initiatives on Coronary Artery Calcification (KOICA) registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248884
Author(s):  
Wonjae Lee ◽  
Yeonyee E. Yoon ◽  
Sang-Young Cho ◽  
In-Chang Hwang ◽  
Sun-Hwa Kim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Risk Group ◽  
Multivariable Analysis ◽  
Low Risk ◽  
Progression Rate ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ascvd Risk ◽  
Male Sex

Even with increasing awareness of sex-related differences in atherosclerotic cardiovascular disease (ASCVD), it remains unclear whether the progression of coronary atherosclerosis differs between women and men. We sought to compare coronary artery calcium (CAC) progression between women and men. From a retrospective, multicentre registry of consecutive asymptomatic individuals who underwent CAC scoring, we identified 9,675 men and 1,709 women with follow-up CAC scoring. At baseline, men were more likely to have a CAC score >0 than were women (47.8% vs. 28.6%). The probability of CAC progression at 5 years, defined as [√CAC score (follow-up)—√CAC score (baseline)] ≥2.5, was 47.4% in men and 29.7% in women (p<0.001). When we stratified subjects according to the 10-year ASCVD risk (<5%, ≥5% and <7.5%, and ≥7.5%), a sex difference was observed in the low risk group (CAC progression at 5 years, 37.6% versus 17.9%; p<0.001). However, it became weaker as the 10-year ASCVD risk increased (64.2% versus 46.2%; p<0.001, and 74.8% versus 68.7%; p = 0.090). Multivariable analysis demonstrated that male sex was independently associated with CAC progression rate among the entire group (p<0.001). Subgroup analyses showed an independent association between male sex and CAC progression rate only in the low-risk group. The CAC progression rate is higher in men than in women. However, the difference between women and men diminishes as the 10-year ASCVD risk increases.

Abstract 13298: The Association Between Coronary Artery Calcium and Atherosclerotic Cardiovascular Disease Risk in Women With Early Menopause: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jian Chu ◽  
Erin D Michos ◽  
Pamela Ouyang ◽  
Dhananjay Vaidya ◽  
Roger S Blumenthal ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Postmenopausal Women ◽  
Coronary Artery Calcium ◽  
Atherosclerotic Cardiovascular Disease ◽  
Early Menopause ◽  
Ethnic Study ◽  
Ascvd Risk

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality among women, and early menopause (EM) is associated with an increased risk for ASCVD. Coronary artery calcium (CAC) is a non-invasive measurement of an individual’s subclinical atherosclerotic burden that is used to refine ASCVD risk estimation, and the absence of CAC is a robust predictor of low 10-year ASCVD risk. However, it is unknown whether there is a difference in the long-term association between the absence of CAC and ASCVD risk between women with and without EM. Objectives: To compare the prevalence of CAC and its association with incident ASCVD between women with and without EM. Methods: We performed Kaplan-Meier survival analysis and multivariable Cox proportional hazards modeling using data from 2,456 postmenopausal women in the Multi-Ethnic Study of Atherosclerosis (MESA) with or without EM, defined as occurring at <45 years of age. Results: Participants had a mean age of 64.1 years, 39% were White, and 28% (n=688) experienced EM. There were 291 ASCVD events over a mean follow-up of 12.5 years. Women with EM had a slightly lower prevalence of CAC=0 (55.1%) than women without EM (59.7%) (p=0.04) despite no difference in mean age. Among women with CAC=0, the cumulative incidence of ASCVD was slightly higher at 10-year follow-up for women with vs. without EM (5.4% vs. 3.2%, p=0.06) and significantly higher at 15-years (11.4% vs. 6.4%, p<0.01) (Figure). In multivariable Cox models, compared to women with CAC=0, those with CAC 1-99 and ≥100 had progressively increased ASCVD risk that did not significantly differ by EM status. Conclusions: More than half of postmenopausal women with EM had CAC=0 and an associated low-to-borderline 10-year risk of ASCVD. When CAC>0, the risk of ASCVD was similar for women with and without EM. Additional research is needed to better understand very long-term differences in ASCVD risk between women with and without EM who have CAC=0.

scholarly journals Ectopic Fat Depots and Coronary Artery Calcium in South Asians Compared With Other Racial/Ethnic Groups

2016 ◽  
Vol 5 (11) ◽  
Author(s):  
Sachin K. Garg ◽  
Feng Lin ◽  
Namratha Kandula ◽  
Jingzhong Ding ◽  
Jeffrey Carr ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ethnic Groups ◽  
Coronary Artery Calcium ◽  
South Asians ◽  
Ectopic Fat ◽  
Fat Depots ◽  
Racial Ethnic

Abstract MP04: 25 year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: the CARDIA Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jamal S Rana ◽  
Rosenda Murillo ◽  
Charles P Quesenberry ◽  
Michael E Sorel ◽  
Barbara Sternfeld ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Middle Age ◽  
Subclinical Atherosclerosis ◽  
Prospective Longitudinal Study ◽  
Men And Women ◽  
Prospective Longitudinal

Background: Physical activity (PA) has been shown to be protective against the development of clinical cardiovascular disease. There is paucity of data regarding the association of long term PA patterns and development of subclinical atherosclerosis, as measured by coronary artery calcium (CAC). Studies so far are limited by evaluation of PA only at baseline. The goal of this study was to identify 25 year patterns of PA from young to middle age and its association with development of CAC. Methods: CARDIA is a prospective longitudinal study of black and white men and women, ages 18-30 years at baseline in 1985-86, with up to 7 follow-up exams over 25 years of follow-up. PA was determined at each exam by a questionnaire that assessed typical PA during the past 12 months for 13 types of activities. Men and women who had at least 3 measures of PA during the 25 years of follow up and CAC assessment at the Year 25 exam were included (N= 3178). CARDIA Physical Activity Score > 300 units is approximately equivalent to >150 min/week of moderate or vigorous physical activity and was considered as meeting PA guidelines (MPAG). Latent class modeling was used to identify unique trajectories of PA. Odds ratios for CAC were estimated from a multivariable logistic model controlling for age, sex, ethnicity, hypertension, diabetes, BMI, smoking status and education. Results: Our analyses showed 5 unique PA trajectories (figure). 1. Maintaining-not MPAG (46.5%); 2. maintaining-MPAG (35.6%); 3 increasing-MPAG (8.5%); 4. decreasing-MPAG (6.5%), and 5. maintaining- > 3 fold MPAG (2.4%). Compared with the maintaining-not MPAG, the multivariable adjusted odds ratio for presence of CAC (non-zero CAC score) was 1.02 (95% CI, 0.84-1.24) for maintaining-MPAG, 1.07 (95% CI, 0.78-1.44) for increasing-MPAG , 1.01(95% CI, 0.72- 1.41) for decreasing-MPAG , and 1.37 (95% CI, 0.82-2.27) for maintaining- > 3 fold MPAG. Conclusion: Long-term trajectories for levels of PA through young adulthood are not associated with development of subclinical atherosclerosis by middle age.

Sign in / Sign up

Export Citation Format

Share Document