Cardiovascular risk-enhancing factors and coronary artery calcium in South Asian American adults: the MASALA study

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• dc.contributor.author Shah, Harini
• dc.contributor.author Garacci, Emma
• dc.contributor.author Behuria, Supreeti
• dc.contributor.author Cainzos-Achirica, Miguel
• dc.contributor.author Kandula, Namratha R.
• dc.contributor.author Kanaya, Alka M.
• dc.contributor.author Shah, Nilay S.
• dc.date.accessioned 2025-04-29T09:44:07Z
• dc.date.available 2025-04-29T09:44:07Z
• dc.date.issued 2023
• dc.description.abstract Objectives. The 2018 and 2019 U.S. guidelines for the management of cholesterol and primary prevention of atherosclerotic cardiovascular disease (ASCVD) recommend consideration of cardiovascular risk-enhancing factors (REFs), including South Asian ancestry, to refine ASCVD risk estimation. However, the associations of REFs with atherosclerosis are unclear in South Asian American adults, who have a disproportionately elevated premature coronary heart disease risk. In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort, we investigated associations of individual REFs, or the number of REFs, with coronary artery calcium (CAC). Methods. Using baseline and follow-up data from MASALA, we evaluated the association of REFs (family history of ASCVD, low-density lipoprotein cholesterol ≥160 mg/dL, triglycerides ≥175 mg/dL, lipoprotein(a) >50 mg/dL, high-sensitivity C-reactive protein [hsCRP] ≥2.0 mg/dL, ankle-brachial index <0.9, chronic kidney disease, metabolic syndrome), individually and combined, with baseline prevalent CAC, any CAC progression (including incident CAC and CAC progression), and annual CAC progression rates using multivariable logistic regression and generalized linear models. Results. Among 866 adults, mean age was 55 [SD 9] years and 47% were female. There were no significant associations of REFs with baseline prevalent CAC or any CAC progression (incident CAC and CAC progression at Exam 2) after adjustment. Among the 56% of participants who had any CAC progression, having 3+ REFs was associated with a significantly higher annual CAC progression rate (adjusted rate ratio [aRR] 1.94, 95% CI 1.39–2.72) vs. having 0 REFs. The annual CAC progression rate was 20% higher per additional REF (aRR 1.20, 95% CI 1.09–1.32). Findings were similar after excluding statin users, and among those with low 10-year ASCVD risk (<5%). Conclusions. Among South Asian American adults, we found no association of REFs with prevalent CAC at baseline or having any CAC progression. Among those with any CAC progression, a higher number of REFs was associated with higher annual CAC progression rates.en
• dc.format.mimetype application/pdf
• dc.identifier.citation Shah H, Garacci E, Behuria S, Cainzos-Achirica M, Kandula NR, Kanaya AM, et al. Cardiovascular risk-enhancing factors and coronary artery calcium in South Asian American adults: the MASALA study. Am J Prev Cardiol. 2023 Mar;13:100453. DOI: 10.1016/j.ajpc.2022.100453
• dc.identifier.doi http://dx.doi.org/10.1016/j.ajpc.2022.100453
• dc.identifier.issn 2666-6677
• dc.identifier.uri http://hdl.handle.net/10230/70233
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof American Journal of Preventive Cardiology. 2023 Mar;13:100453
• dc.rights © 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword South Asianen
• dc.subject.keyword Risken
• dc.subject.keyword Cardiovascular diseaseen
• dc.subject.keyword Coronary artery calciumen
• dc.title Cardiovascular risk-enhancing factors and coronary artery calcium in South Asian American adults: the MASALA studyen
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion