TY - JOUR
T1 - Comparison of coronary atherosclerotic plaque progression in East Asians and Caucasians by serial coronary computed tomographic angiography
T2 - A PARADIGM substudy
AU - Ben Zekry, Sagit
AU - Sreedharan, Subhashaan
AU - Han, Donghee
AU - Sellers, Stephanie
AU - Ahmadi, Amir A.
AU - Blanke, Philipp
AU - Hadamitzky, Martin
AU - Kim, Yong Jin
AU - Conte, Edoardo
AU - Andreini, Daniele
AU - Pontone, Gianluca
AU - Budoff, Matthew J.
AU - Gottlieb, Ilan
AU - Lee, Byoung Kwon
AU - Chun, Eun Ju
AU - Cademartiri, Filippo
AU - Maffei, Erica
AU - Marques, Hugo
AU - Shin, Sanghoon
AU - Choi, Jung Hyun
AU - Virmani, Renu
AU - Samady, Habib
AU - Stone, Peter H.
AU - Berman, Daniel S.
AU - Narula, Jagat
AU - Shaw, Leslee J.
AU - Bax, Jeroen J.
AU - Leipsic, Jonathon
AU - Chang, Hyuk Jae
N1 - Publisher Copyright:
© 2022
PY - 2022/5/1
Y1 - 2022/5/1
N2 - 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.
AB - 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.
KW - Caucasian
KW - East Asian
KW - Plaque progression
UR - http://www.scopus.com/inward/record.url?scp=85118570486&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2021.09.012
DO - 10.1016/j.jcct.2021.09.012
M3 - Article
C2 - 34736879
AN - SCOPUS:85118570486
SN - 1934-5925
VL - 16
SP - 222
EP - 229
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
IS - 3
ER -