Using coronary CTA, researchers were able to detect differences in
atherosclerotic plaque burden and composition between black and white patients,
which highlighted the presence of more non-calcified disease in blacks and more
calcified disease in whites.
For a long time, physicians have searched for explanations as to
why African Americans have higher rates of heart disease and higher cardiac
death rates, but less coronary artery calcium than Caucasians, U.
Joseph Schoepf, MD, director of CV imaging at Medical University of South
Carolina, Charleston, and study investigator, said in a press release. We
show that one possible explanation for the discrepancy may be found in the
higher rate of less stable, non-calcified plaque in the heart vessels of
U. Joseph Schoepf
All patients (n=301; 50.2% white, 49.8% black) in the analysis had acute
chest pain and underwent coronary CT angiographic examination that included the
evaluation of each coronary artery segment for the presence of atherosclerotic
plaque, plaque composition and stenosis.
According to results, with the exception of diabetes, which was higher
in blacks (P=.003), no other difference in a CV risk factor reached
statistical significance between white and black patients. Overall, the
presence of any plaque and stenosis did not significantly differ between white
and black patients. However, other characteristics did, including higher rates
in blacks of prevalence (64% vs. 41%; P<.001) and volume (2.2 mL vs.
1.4 mL; P<.001) of non-calcified plaque independent of CV risk
factors, as well as a lower prevalence of
calcified plaque (26% vs. 45%; P=.001).
For African-American patients,
coronary CTA may be a more appropriate screening tool for CV
risk, Schoepf said.
Disclosure: Dr. Schoepf reported no relevant financial