Association Between Asian Ethnicity and Premature Coronary Artery Disease

Objectives: It is well known that Asians have an increased prevalence of CAD. This study investigated the association between the prevalence of"premature"CAD (i.e. CAD in men < 40 and women < 50) and ethnicity, with a focus on Asian ethnicity. Methods: Our study included 1,386 young adults who underwent coronary CT angiography (CCTA) at a single institution. Ethnicity and other demographic variables were recorded. For all plaques identified on CCTA, the blood vessel and segment affected was recorded. Plaques were characterized as calcified, non-calcified, or mixed, and the degree of stenosis was assessed based on the CAD-RADS reporting system. Results:The prevalence of premature CAD was over twice as high among Asians (p=0.003, 33.3%, 19.0%-47.6%) (Mean, 95% CI.) compared to Whites (16.0%, 13.1%-18.8%), Blacks (12.4%, 8.5%-16.2%), and Latinos (12.3%, 9.2%-15.4%). The majority of plaques among all ethnic groups were non-calcified plaques identified in the proximal segment of the LAD. There was no relationship between ethnicity and plaque type (p=0.617) or location (p=0.788). Conclusion: Asians are not only at an increased likelihood of developing CAD, but the atherosclerotic disease process begins at an earlier age compared with patients of other ethnicities. Atherosclerotic plaque characteristics are similar among all ethnicities.