Prevalence of sub clinical atherosclerosis among UK South Asians and Europeans
South Asians demonstrate high coronary heart disease mortality, largely unexplained by conventional risk factors and unidentified by risk stratification tools. Developments in technology allow us to visualize coronary atherosclerosis non-invasively, thus providing the potential to identify presence of coronary atherosclerosis before it manifests clinically. Coronary artery calcification is closely correlated with total plaque burden and provides an assessment of coronary plaque burden.
... l perfusion scintigraphy provides an estimate of myocardial blood flow and thus, severity of coronary artery disease. Increased coronary artery calcification and silent myocardial ischemia predict future risk of coronary heart disease mortality, independent of conventional factors. Inflammation is a key factor in initiation and progression of atherosclerosis. High sensitivity C-reactive protein (CRP) is an important marker of active inflammation and is considered an independent predictor of future cardiovascular events. Thus, markers of subclinical atherosclerosis and inflammation could provide us with a tool for early identification of South Asians at risk of coronary events, unidentified by traditional means. However, majority of the data for such markers is from North American and European populations, with no data evaluating the role of coronary artery calcification, myocardial perfusion scintigraphy and CRP in assessing the coronary heart disease risk in South Asians. Methods and Results: I carried out assessments including coronary artery calcium, myocardial perfusion imaging and assessment of high sensitivity C-reactive protein for a cohort of asymptomatic South Asians and Europeans men and women, aged 35 to 75 years, who were part of the London Life Sciences Population (LOLIPOP) study. I found that: 1) Coronary artery calcification scores were closely associated with age, male gender, cigarette smoking, hypertension, systolic blood pressure, diabetes and total cholesterol. 2) There were no differences i [...]