比较无症状南亚裔、白人和黑人参与者的冠状动脉横截面积：MASALA 和 CARDIA 研究。
Comparing coronary artery cross-sectional area among asymptomatic South Asian, White, and Black participants: the MASALA and CARDIA studies.
机构信息
University of California San Francisco, San Francisco, USA.
Vanderbilt University Medical Center, Nashville, USA.
出版信息
BMC Cardiovasc Disord. 2024 Mar 14;24(1):158. doi: 10.1186/s12872-024-03811-4.
BACKGROUND
South Asian individuals have high risk of atherosclerotic cardiovascular disease (ASCVD). Some investigators suggest smaller coronary artery size may be partially responsible.
METHODS
We compared the left anterior descending (LAD) artery cross-sectional area (CSA) (lumen and arterial wall) among South Asians in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study with White and Black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, adjusting for BMI, height, and other ASCVD risk factors. We used thin-slice non-contrast cardiac computed tomography to measure LAD CSA. We used linear regression models to determine whether race/ethnicity was associated with LAD CSA after adjusting for demographic factors, BMI, height, coronary artery calcium (CAC), and traditional cardiovascular risk factors.
RESULTS
Our sample included 3,353 participants: 513 self-identified as South Asian (44.4% women), 1286 as Black (59.6% women), and 1554 as White (53.5% women). After adjusting for age, BMI, height, there was no difference in LAD CSA between South Asian men and women compared to White men and women, respectively. After full adjustment for CVD risk factors, LAD CSA values were: South Asian women (19.9 mm, 95% CI [18.8 - 20.9]) and men (22.3 mm, 95% CI [21.4 - 23.2]; White women (20.0 mm, 95% CI [19.4-20.5]) and men (23.6 mm, 95% CI [23.0-24.2]); and Black women (21.6 mm, 95% CI [21.0 - 22.2]) and men (26.0 mm, 95% CI [25.3 - 26.7]). Height, BMI, hypertension, CAC, and age were positively associated with LAD CSA; current and former cigarette use were inversely associated.
CONCLUSIONS
South Asian men and women have similar LAD CSA to White men and women, and smaller LAD CSA compared to Black men and women, respectively, after accounting for differences in body size. Future studies should determine whether LAD CSA is associated with future ASCVD events.
背景
南亚个体患动脉粥样硬化性心血管疾病（ASCVD）的风险较高。一些研究人员认为，较小的冠状动脉大小可能是部分原因。
方法
我们比较了生活在美国的南亚动脉粥样硬化代谢物研究（MASALA）中的南亚人与冠状动脉风险发展在年轻人中（CARDIA）研究中的白人和黑人参与者的左前降支（LAD）冠状动脉横截面积（CSA）（管腔和动脉壁），并调整了 BMI、身高和其他 ASCVD 风险因素。我们使用薄层非对比心脏计算机断层扫描来测量 LAD CSA。我们使用线性回归模型来确定在调整人口统计学因素、BMI、身高、冠状动脉钙（CAC）和传统心血管危险因素后，种族/民族是否与 LAD CSA 相关。
结果
我们的样本包括 3353 名参与者：513 名自认为是南亚人（44.4%是女性），1286 名是黑人（59.6%是女性），1554 名是白人（53.5%是女性）。调整年龄、BMI、身高后，南亚男性和女性与白人男性和女性相比，LAD CSA 无差异。在充分调整 CVD 风险因素后，LAD CSA 值分别为：南亚女性（19.9mm，95%CI[18.8-20.9]）和男性（22.3mm，95%CI[21.4-23.2]）；白人女性（20.0mm，95%CI[19.4-20.5]）和男性（23.6mm，95%CI[23.0-24.2]）；和黑人女性（21.6mm，95%CI[21.0-22.2]）和男性（26.0mm，95%CI[25.3-26.7]）。身高、BMI、高血压、CAC 和年龄与 LAD CSA 呈正相关；当前和以前的吸烟与 LAD CSA 呈负相关。
结论
在考虑到体型差异后，南亚男性和女性的 LAD CSA 与白人男性和女性相似，而与黑人男性和女性相比，LAD CSA 较小。未来的研究应确定 LAD CSA 是否与未来的 ASCVD 事件相关。
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