Distribution of calcium volume, density, number, and type of coronary vessel with calcified plaque in South Asians in the US and other race/ethnic groups: The MASALA and MESA studies

Leveling the playing field: The utility of coronary artery calcium scoring in cardiovascular risk stratification in South Asians

“…Significant coronary artery disease (CAD) (>50% stenosis) was more frequent in the left anterior descending coronary artery among asymptomatic SA adults compared to NHW adults with diabetes mellitus [41] . Compared to NHW, SA have significantly lower CAC volume but higher CAC density when accounting for traditional risk factors [42] . As noted by the authors, higher CAC density may reflect stable plaque (less likely to rupture), which is influenced by statin use (pro-calcific effects) [ 42 , 43 ].…”

“…Plaque characteristics beyond the traditional CAC score may be helpful when assessing ASCVD risk. SA adults have a higher number of vessels with calcified plaque compared to other race/ethnicities [ 41 , 42 ]. Significant coronary artery disease (CAD) (>50% stenosis) was more frequent in the left anterior descending coronary artery among asymptomatic SA adults compared to NHW adults with diabetes mellitus [41] .…”

Evaluating coronary atherosclerosis progression among South Asians

“…A prior crosssectional study found that SA men had similar CAC burden as Whites but higher CAC burden compared to other race/ethnic groups, while SA women had a similar CAC burden as other race/ethncities [15]. SA men had lower CAC volume and number of vessels with calcified plaque but higher CAC density compared to White men [16]. However, SA women had higher CAC density and CAC volume in most epicardial coronary arteries compared to White women.…”

South Asian cardiovascular disease: Dispelling stereotypes and disparity

“…For example, our results suggest that the extent of ASCVD-risk overestimation using the PCE is greater among South Asian adults considered at low/intermediate risk than among White adults, such that intermediate-risk South Asian individuals have a 73% higher odds of CAC=0 (very low 10-year risk of ASCVD) [5] . Favorably, South Asian adults have lower CAC volume and higher CAC density, but a higher number of calcified vessel when compared White individuals [ 6 , 7 ]. Outcome data are required to confirm the importance of these findings and should be available as the MASALA Study matures [6] .…”

“…Favorably, South Asian adults have lower CAC volume and higher CAC density, but a higher number of calcified vessel when compared White individuals [ 6 , 7 ]. Outcome data are required to confirm the importance of these findings and should be available as the MASALA Study matures [6] . With respect to biomarkers [Lp(a), tumor necrosis factor-alpha, adiponectin, and leptin], we did not find an association with CAC presence or severity, suggesting markers of inflammation and cardiometabolic risk are independent of CAC and that CAC has a distinct pathophysiology independent of inflammation [8] .…”