Mediators of Atherosclerosis in South Asians Living in America

 描述(申请人提供)：这个项目的目标是填补我们对南亚人心脏病先兆的了解的空白，特别是关注冠状动脉钙化斑块。我们已经建立了一个南亚人的前瞻性队列，称为在美国生活的南亚人动脉粥样硬化的介体(MASLA)研究，该研究与多种族动脉粥样硬化研究(MESA)密切相关，以进行有效的跨种族比较。我们发现南亚人有明显更高的几个传统心血管危险因素的患病率，异位体脂沉积的独特分布，以及高冠状动脉钙负荷。我们建议通过测量斑块进展和增加冠状动脉斑块的新方法来利用Masala队列基线数据来调查南亚人动脉粥样硬化性心血管疾病(ASCVD)的流行病学、病因学和自然病史。在此次Masala研究拨款的更新中，我们建议通过重复心脏计算机断层扫描来确定冠状动脉斑块的进展，从现有的基线扫描中测量先进的冠状动脉斑块特征(钙密度和斑块分布)，并在大约875名南亚人中确定ASCVD事件的关键预测因素。我们的目标是1)调查南亚人4年后CAC的进展率，并比较台地种族/民族的年化进展率；2)确定南亚人中晚期冠状动脉斑块特征的患病率和相关性，比较四个台地种族/民族的患病率和相关性；以及3)确定CAC和冠状动脉斑块特征是否与南亚人的心肌梗死和ASCVD事件相关。研究这一高风险民族队列可以为动脉粥样硬化性疾病的发病机制提供新的见解，而这些疾病是在关注其他种族/民族的研究中观察不到的。

 DESCRIPTION (provided by applicant): The goal of this project is to fill gaps in our understanding of the antecedents of heart disease in South Asians, specifically focusing on coronary artery calcified plaque. We have established a prospective cohort of South Asians called the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study which is closely tied to the Multi-Ethnic Study of Atherosclerosis (MESA) for efficient cross-ethnic comparisons. We have found that South Asians have significantly higher prevalence of several traditional cardiovascular risk factors, a unique distribution of ectopic body fat deposition, and a high coronary artery calcium burden. We propose to leverage the MASALA cohort baseline data by measuring plaque progression and adding novel measures of coronary plaque to investigate the epidemiology, etiology and natural history of atherosclerotic cardiovascular disease (ASCVD) in South Asians. In this renewal of the MASALA study grant, we propose to determine the progression of coronary plaque by repeating a cardiac computed tomography scan, measure advanced coronary plaque characteristics (calcium density and plaque distribution) from existing baseline scans, and identify the key predictors of ASCVD events among approximately 875 South Asians. Our aims are to 1) investigate the rate of CAC progression among South Asians after 4 years of follow-up, and compare annualized progression rates to the MESA race/ethnic groups; 2) determine the prevalence and correlates of advanced coronary plaque characteristics among South Asians and compare the prevalence and correlates with the four MESA race/ethnic groups; and 3) determine whether CAC and coronary plaque characteristics are associated with incident myocardial infarction and ASCVD events among South Asians. Studying this high risk ethnic cohort could provide novel insights into the pathogenesis of atherosclerotic disease that cannot be observed in studies focusing on other race/ethnic groups.