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- Title:
Comparison of coronary atherosclerotic plaque progression in East Asians and Caucasians by serial coronary computed tomographic angiography: A PARADIGM substudy.
- Document type:
- Journal Article
- Author(s):
- Ben Zekry, Sagit; Sreedharan, Subhashaan; Han, Donghee; Sellers, Stephanie; Ahmadi, Amir A; Blanke, Philipp; Hadamitzky, Martin; Kim, Yong-Jin; Conte, Edoardo; Andreini, Daniele; Pontone, Gianluca; Budoff, Matthew J; Gottlieb, Ilan; Lee, Byoung Kwon; Chun, Eun Ju; Cademartiri, Filippo; Maffei, Erica; Marques, Hugo; Shin, Sanghoon; Choi, Jung Hyun; Virmani, Renu; Samady, Habib; Stone, Peter H; Berman, Daniel S; Narula, Jagat; Shaw, Leslee J; Bax, Jeroen J; Leipsic, Jonathon; Chang, Hyuk-Jae
- Abstract:
- OBJECTIVES: To investigate potential differences in plaque progression (PP) between in East Asians and Caucasians as well as to determine clinical predictors of PP in East Asians. BACKGROUND: Studies have demonstrated differences in cardiovascular risk factors as well as plaque burden and progression across different ethnic groups. METHODS: The study comprised 955 East Asians (age 60.4 ± 9.3 years, 50.9% males) and 279 Caucasians (age 60.4 ± 8.6 years, 74.5% males) who underwent two serial coronary computed tomography angiography (CCTA) studies over a period of at least 24 months. Patients were enrolled and analyzed from the PARADIGM (Progression of AtheRosclerotic PlAque DetermIned by Computed TomoGraphic Angiography IMaging) registry. After propensity-score matching, plaque composition and progression were compared between East Asian and Caucasian patients. Within East Asians, the plaque progression group (defined as plaque volume at follow-up CCTA minus plaque volume at baseline CCTA> 0) was compared to the no PP group to determine clinical predictors for PP in East Asians. RESULTS: In the matched cohort, baseline volumes of total plaque as well as all plaque subtypes were comparable. There was a trend towards increased annualized plaque progression among East Asians compared to Caucasians (18.3 ± 24.7 mm3/year vs 16.6 mm3/year, p = 0.054). Among East Asians, 736 (77%) had PP. East Asians with PP had more clinical risk factors and higher plaque burden at baseline (normalized total plaque volume of144.9 ± 233.3 mm3 vs 36.6 ± 84.2 mm3 for PP and no PP, respectively, p < 0.001). Multivariate logistic regression analysis showed that baseline normalized plaque volume (OR: 1.10, CI: 1.10-1.30, p < 0.001), age (OR: 1.02, CI: 1.00-1.04, p = 0.023) and body mass index (OR: 2.24, CI: 1.01-1.13, p = 0.024) were all predictors of PP in East Asians. Clinical events, driven mainly by percutaneous coronary intervention, were higher among the PP group with a total of 124 (16.8%) events compared to 22 (10.0%) in the no PP group (p = 0.014). CONCLUSION: East Asians and Caucasians had comparable plaque composition and progression. Among East Asians, the PP group had a higher baseline plaque burden which was associated with greater PP and increased clinical events.
- Journal title abbreviation:
- J Cardiovasc Comput Tomogr
- Year:
- 2022
- Journal volume:
- 16
- Journal issue:
- 3
- Pages contribution:
- 222-229
- Fulltext / DOI:
- doi:10.1016/j.jcct.2021.09.012
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/34736879
- Print-ISSN:
- 1934-5925
- TUM Institution:
- Institut für Radiologie und Nuklearmedizin
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