Atherosclerotic plaque characteristics differ between black, white patients

Nance JW. Radiology. 2011;doi:10.1148/radiol.11110158.

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 African Americans.”

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 disclosures.

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