Royal Perth Hospital, Perth, Western Australia, Australia.
Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
Int J Cardiovasc Imaging. 2020 Dec;36(12):2347-2355. doi: 10.1007/s10554-020-01802-y. Epub 2020 Mar 4.
Low-attenuation plaques (LAPs) are associated with an increased risk of cardiovascular mortality and morbidity. South Asians experience poorer cardiovascular outcomes compared to Caucasian populations. We hypothesised that South Asian population has a higher prevalence of LAP compared to Caucasians and this difference predicts major adverse cardiovascular events. 72 Caucasian and 72 Morise score-matched South Asian patients were identified from a cardiac computed tomography angiography (CCTA) registry. Coronary artery plaque subtypes in proximal major epicardial and left main arteries were analysed from CCTA images using pre-determined attenuation ranges in Hounsfield units (HUs): 1 to 30 HU (low attenuation), 31 to 70 HU (intermediate attenuation), 71 to 150 HU (high attenuation), and mean coronary lumen + 2 standard deviations to 1000 HU (calcified). For each analysis, data comparison was performed for plaque volumes after normalising for the corresponding coronary artery outer vessel wall volume. The baseline characteristics and total plaque score of the two cohorts were similar. There were no statistically significant differences in low, intermediate, and high- attenuation, or calcified normalised plaque volumes between Caucasian and Morise score-matched South Asian cohorts. After a mean follow up of 32 months, major adverse cardiovascular events were similar between Caucasians and South Asians. In a Morise score-matched ethnicity study, we found no significant differences in plaque subtypes including LAP in South Asians compared to a Caucasian cohort. Other factors accounting for poor outcomes in South Asians should be investigated.
低衰减斑块（LAP）与心血管死亡率和发病率增加相关。南亚人比高加索人群的心血管结局更差。我们假设南亚人群的 LAP 患病率高于高加索人群，这种差异可以预测主要不良心血管事件。从心脏 CT 血管造影（CCTA）注册中确定了 72 名高加索人和 72 名 Morise 评分匹配的南亚患者。使用 Hounsfield 单位（HU）的预先确定的衰减范围从 CCTA 图像分析近端主要心外膜和左主干动脉的冠状动脉斑块亚型：1 至 30 HU（低衰减），31 至 70 HU（中衰减），71 至 150 HU（高衰减），以及平均冠状动脉管腔+2 个标准偏差至 1000 HU（钙化）。对于每种分析，在对相应的冠状动脉外血管壁体积进行归一化后，比较斑块体积数据。两个队列的基线特征和总斑块评分相似。高加索人和 Morise 评分匹配的南亚人群之间，低、中、高衰减或钙化归一化斑块体积没有统计学上的显著差异。在平均 32 个月的随访后，高加索人和南亚人之间的主要不良心血管事件相似。在 Morise 评分匹配的种族研究中，我们发现南亚人和高加索人群之间的斑块亚型（包括 LAP）没有显著差异。应该调查导致南亚人不良结局的其他因素。
