Skip to main content
. Author manuscript; available in PMC: 2023 Dec 12.
Published in final edited form as: JACC Adv. 2023 Mar 31;2(2):100258. doi: 10.1016/j.jacadv.2023.100258

TABLE 4.

Summary of Advanced Measures of CAC in South Asian Adults

Author Study Main Finding(s)
Kanaya et al109 MASALA, MESA

  • South Asian and NHW men have similar CAC burden (mean age 58 ± 9y vs 63 ± 10 y), but higher CAC burden compared to other race/ethnic groups (mean age 62 ± 10y).

  • CAC scores were similar for South Asian women compared to all women of other racial/ethnic groups; however, South Asian women >70 y had a higher prevalence of any CAC than most other racial/ethnic groups.
Al Rifai et al254 MASALA, MESA

  • South Asian adults have a higher number of vessels with calcified plaque compared to other racial/ethnic groups, OR (95% CI): 0.29 (0.17, 0.40) (P < 0.05).

  • Compared to NHW, South Asian adults have significantly lower CAC volume [beta coefficient (95% CI), −0.46 (−0.62, −0.29)] but higher overall CAC density [beta coefficient (95% CI)], 0.14 (0.11, 0.18)].

  • South Asian adults had higher (OR, 95% CI) overall [0.07 (0.03, 0.12)] and RCA [0.09 (0.03, 0.16)] CAC density compared to other racial/ethnic groups.
Roos et al250 Observational Cohort

  • Compared to White adults, South Asian adults patients had a significantly higher CAC score and higher prevalence of significant CAD (41% vs 28%, respectively, P = 0.008), involving more coronary vessels and segments.

  • Significant CAD (>50% stenosis) was more frequent in the left anterior descending coronary artery among asymptomatic South Asian adults compared to White adults with T2D.
Al Rifai et al249 MASALA

  • The PCE was associated with both CAC density [beta coefficient (95% CI), 0.24 (0.12, 0.35)] and CAC volume (beta coefficient (95% CI), 0.43 (0.38, 0.48).

  • HDL-C was directly associated with CAC density and waist circumference was inversely associated with CAC density (P < 0.05).

  • Body mass index, hypertension status, statin use, diabetes, and HOMA-IR were all directly associated with CAC volume (P < 0.05).
Kanaya et al264 MASALA, MESA

  • Age-adjusted CAC incidence was similar in South Asian men compared with White, Black, and NHW men, but significantly higher than Chinese men (11.1% vs 5.7%, P = 0.008).

  • There was no difference in CAC incidence or progression between South Asian women and women of other racial/ethnic groups.
Bhatia et al255 MASALA

  • CAC volume and density were highest, and incident CAC was most common in the left anterior descending artery.

  • Highest volume change was in the right coronary artery.

  • Highest change in density was in the left main coronary artery.

  • Smoking is associated with CAC volume progression.

  • Lipoprotein(a) and exercise are associated with CAC density progression.
Patel et al169 MASALA, MESA

  • Compared to other racial/ethnic groups, the presence of an FamHx in South Asian adults is associated with CAC > 300, OR (95% CI): 2.82 (1.6-4.93).

  • The presence of an FamHx provides significant information for the prediction and reclassification of severe CAC in South Asians: c-statistic increase from 0.853 to 0.863 (P = 0.001), net reclassification improvement 38.9% (95% CI: 14.6%-62.6%].
Wang et al170 SABRE

  • South Asian adults with FamHx had a trend toward increased CAC burden compared with Europeans, OR 95% CI: 1.28, 0.85-1.93 (P = 0.243).

CAC = coronary artery calcium; CI = confidence interval; FamHx = family history of CHD; HOMA-IR = homeostatic model assessment for insulin resistance; MASALA = Mediators of Atherosclerosis in South Asians Living in America;NHW = non-Hispanic White; OR = odds ratio; PCE = pooled cohort equations; SABRE = South Hall and Brent Revisited study; T2D = type 2 diabetes.