African Americans with coronary artery calcium scores ≥400 had a >16.1-fold higher relative risk of 10-year all-cause mortality compared to non-Hispanic whites (p<0.0001).
Cohort (n=14,812)
Does coronary artery calcium (CAC) scoring predict all-cause mortality differently across ethnic groups in a diverse patient cohort?
African Americans with a high burden of subclinical coronary artery disease (CAC ≥400) have a substantially higher risk of all-cause mortality compared to other ethnic groups.
Relative Risk: 16.1
p-value: p=<0.0001
OBJECTIVES The purpose of this study was to evaluate the prognostic value of coronary artery calcium (CAC), a known marker of subclinical atherosclerosis, in a large, ethnically diverse cohort of 14,812 patients for the prediction of all-cause mortality. BACKGROUND Disparities in case fatality rates for heart disease among ethnic groups are well known. In 2001, rates of death from heart disease were 30% higher among African Americans (AA) than non-Hispanic whites (NHW). Some of this variability may be due to differing pathophysiological mechanisms and effects of underlying atherosclerosis. METHODS Ten-year death rates from all causes (total deaths = 505) were compared using risk-adjusted Cox proportional hazards models in AA (n = 637), Hispanic (HS, n = 1,334), Asian (AS, n = 1,065), and NHW (n = 11,776) populations. RESULTS Ethnic minority patients were generally younger (0.3 to 4 years), more often persons with diabetes (p or =100 was highest in NHW (31%) and lowest for HS (18%) (p or =400 exceeding 16.1 (p or =400 had relative risk ratios from 7.9 to 9.0, whereas AS with CAC scores > or =1,000 had relative risk ratios 6.6-fold higher than NHW (p < 0.0001). CONCLUSIONS Consistent with population evidence, AA with increasing burden of subclinical coronary artery disease were the highest-risk ethnic minority population. These data support a growing body of evidence noting substantial differences in cardiovascular risk by ethnicity.
Nasir et al. (Tue,) conducted a cohort in Subclinical atherosclerosis (n=14,812). Coronary artery calcium (CAC) score vs. Non-Hispanic whites (NHW) was evaluated on 10-year all-cause mortality (RR >16.1, p=<0.0001). African Americans with coronary artery calcium scores ≥400 had a >16.1-fold higher relative risk of 10-year all-cause mortality compared to non-Hispanic whites (p<0.0001).