Coronary atherosclerotic plaque burden and composition as assessed on CT angiography in East Asian and Caucasian populations.

Oxford University Press Netherlands 2019-04-22

Background: When compared with Caucasian populations, East Asians (EA) have a lower prevalence of coronary artery disease, myocardial infarction and cardiovascular mortality. Ethnic differences in coronary atherosclerotic burden and plaque composition are not known. Objective(s): To compare CT-assessed coronary atherosclerotic burden, plaque composition and quantitative high risk plaque features in a matched cohort of Caucasian and EA patients with stable chest pain. Method(s): Two-hundred symptomatic patients (age 58.8+/-7.9, male 51%) underwent clinically mandated CT coronary angiography (CTA) were matched for age, gender, BMI and diabetes (100 for each ethnic group). Visual CTA assessment and quantitative plaque analysis using dedicated semiautomatic software was performed by a blinded core laboratory to measure plaque volume and burden. Plaque composition was determined from measurement of total, calcified and non-calcified plaque (NCP) volumes. NCP was further separated by differences in Hounsfield Units (HU). Quantitative high risk plaque features were defined as low attenuation necrotic core (-30 to 30 HU) and intermediate fibrofatty plaque (31-130 HU). Favourable plaque was defined as high attenuation fibrous plaque (131-350 HU). Result(s): Segment Involvement Score, percent diameter and area stenosis were comparable in both groups. Similarly, there was no significant difference in total plaque, calcified and non-calcified plaque volume and burden. Compared with Caucasians, plaque composition in East Asians was associated with significantly less high risk features of necrotic core (3.47 vs 5.09%, P=0.003) and fibrofatty plaque (29.28 vs 37.20% P=0.002). Fibrous plaque composition was highest in East Asians (65.65 vs 57.58% P=0.009). Conclusion(s): Based on this matched cohort with comparable overall plaque volume and burden, East Asians exhibited significantly lower composition of high risk plaque features and had higher favourable plaque composition compare

thorax pain; conference abstract; major clinical study; atherosclerotic plaque; attenuation; body mass; Caucasian; clinical assessment; cohort analysis; computed tomographic angiography; controlled study; core laboratory; coronary angiography; coronary artery disease; diabetes mellitus; East Asian; ethnic group; female; gender; heart infarction; human; adult; male; quantitative analysis; software; stenosis; Conference Abstract

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Copyright 2019 Elsevier B.V., All rights reserved.

AUSHL oai:repository.monashhealth.org:1/37749
European Heart Journal. Conference: European Society of Cardiology Congress, ESC 2018. Munich Germany. 39 (Supplement 1) (pp 369), 2018. Date of Publication: August 2018.
1522-9645
https://repository.monashhealth.org/monashhealthjspui/handle/1/37749
Monash Health
627250738
(Ihdayhid, Adams, Nerlekar, Yap, Thakur, Cameron, Seneviratne, Ko) Monash Cardiovascular Research Centre, Monash University and Monash-Heart, Monash Health, Melbourne, Australia (Goeller, Achenbach) Friedrich Alexander University, Department of Cardiology, Erlangen, Germany (Dey) Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, United States
(Goeller, Achenbach) Friedrich Alexander University, Department of Cardiology, Erlangen, Germany
(Dey) Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, United States
(Ihdayhid, Adams, Nerlekar, Yap, Thakur, Cameron, Seneviratne, Ko) Monash Cardiovascular Research Centre, Monash University and Monash-Heart, Monash Health, Melbourne, Australia
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