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Coronary atherosclerosis in African American and white patients with acute chest pain: characterization with coronary CT angiography.

Abstract：

PURPOSE:To use coronary computed tomographic (CT) angiography to compare the prevalence, extent, and composition of coronary atherosclerotic lesions in African American and white patients with acute chest pain. MATERIALS AND METHODS:The institutional review board waived the requirement for informed consent for this retrospective, HIPAA-compliant matched-cohort study. The authors analyzed the CT angiographic data of 301 patients (150 consecutive African American patients; 151 white control patients; mean age, 55 years ± 11 [standard deviation]; 33% male) with acute chest pain. Each coronary artery segment was evaluated for presence of atherosclerotic plaque, plaque composition (calcified, noncalcified, or mixed), and stenosis. In addition, the noncalcified plaque volume was quantified by using a threshold-based automated algorithm. The presence and extent of atherosclerotic plaque were compared between the groups by using univariate and multivariate regression analyses. RESULTS:While there was no significant difference between the African American and white patients with respect to presence of any plaque (118 [79%] of 150 vs 112 [74%] of 151 patients, respectively; P = .36) or presence of stenosis (26 [17%] vs 37 [24%] patients, respectively; P = .13), the African American patients had a significantly higher prevalence (96 [64%] vs 62 [41%] patients, respectively; P < .001) and volume (median volume, 2.2 vs 1.4 mL, respectively; P < .001) of noncalcified plaque, independent of diabetes and other cardiovascular risk factors (odds ratio, 2.45; 95% confidence interval: 1.52, 4.04). In contrast, the African American patients had a lower prevalence of calcified plaque (39 [26%] vs 68 [45%] white patients, P = .001). CONCLUSION:Study results suggest that atherosclerotic plaque burden and composition, as measured by using coronary CT angiography, differ between African American and white patients, with relatively more noncalcified disease in African Americans and more calcified disease in white individuals. Further research is warranted to determine whether CT plaque characterization can improve cardiac risk prediction in African Americans.

journal_name

Radiology

journal_title

Radiology

authors

Nance JW Jr,Bamberg F,Schoepf UJ,Kang DK,Barraza JM Jr,Abro JA,Bastarrika G,Headden GF,Costello P,Thilo C

doi

10.1148/radiol.11110158

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

373-80

issue

eissn

0033-8419

issn

1527-1315

pii

radiol.11110158

journal_volume

260

pub_type

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Coronary atherosclerosis in African American and white patients with acute chest pain: characterization with coronary CT angiography.