Separate and Not Equal

Study suggests different cardiovascular screening tool for African-Americans

(RxWiki News) African-Americans, despite having lower amounts of coronary artery calcification, are at increased risk of cardiovascular events compared to Caucasians.

Coronary CT angiography (cCTA), which provides a more comprehensive picture of the arteries than traditional CT screening, is an effective and noninvasive tool that appearsto be better at diagnosing heart disease in black patients. cCTA picks up the presence of non-calcified and mixed plaques, which may be found more commonly in African-Americans, according to researchers at the Medical University of South Carolina (MUSC) in Charleston, S.C.

Calcium scoring with CT is a common screening tool for patients at risk for cardiovascular disease. Increased calcification in the coronary arteries correlates with a greater risk of a heart attack or other cardiovascular event. However, this approach does not detect non-calcified plaque, the kind MUSC researchers believe to be more prevalent among African-Americans.

Non-calcified plaque consists of buildups of soft deposits deep in the walls of the arteries that are not detected by some cardiac tests like the CT. This type of plaque is more vulnerable to rupturing and causing a blood clot, which could then lead to a heart attack or stroke.

The MUSC study looked at 50 percent each of African-American and Caucasian patients with a mean age of 55. Calcified plaque was much more prevalent in the coronary arteries of Caucasian patients (45 percent) than in the African-Americans (26 percent). Conversely African-American patients (64 percent) exhibited higher amounts of non-calcified plaque than did Caucasians (41 percent).

"This study confirms that the coronary artery disease pathways that lead to acute cardiovascular events are different for Caucasians and African-Americans," said coauthor U. Joseph Schoepf, M.D., professor of radiology and medicine and director of cardiovascular imaging at MUSC. "Coronary CT angiography is an effective and noninvasive tool for studying the pathology of atherosclerosis among different ethnicities."

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Review Date: 
November 30, 2010