Racial Disparities in the Cardiac Computed Tomography Assessment of Coronary Artery Disease: Does Gender Matter

Department

Internal Medicine

Document Type

Article

Publication Title

Cardiology in Review

Abstract

Coronary heart disease (CHD) represents a significant healthcare burden in terms of hospital resources, morbidity, and mortality. Primary prevention and early detection of risk factors for the development of CHD are pivotal to successful intervention programs and prognostication. Yet, there remains a paucity of evidence regarding differences in the assessment of these risk factors and the tools of assessment among different ethnicities. We conducted a narrative review to assess the utility of cardiac computed tomography, particularly coronary artery calcification (CAC), in different ethnicities. We also looked to see whether age, sex, comorbidities, and genetic background have peculiar influences on CAC. In this review, we highlight some of the pivotal studies regarding the question of CAC in relation to the development of CHD among different ethnicities. We identify several key trends in the literature showing that although African Americans have high rates of CHD, their risk of CAC may be relatively lower compared with other ethnicities. Similarly, South Asian patients may be at a high risk for adverse cardiac events due to elevated CAC. We also note that several studies are limited by small sample size and were based on 1 large cohort study. Future studies should include a large international prospective cohort to truly evaluate the effects of ethnicity on CAC and CHD risk. To appropriately apply CAC in the clinical practice, the variations in its scoring based on a subject's age, sex, comorbidity, and ethnicity should be addressed and interpreted beforehand.

First Page

14

Last Page

22

DOI

10.1097/CRD.0000000000000206

Volume

27

Issue

1

Publication Date

1-1-2019

Medical Subject Headings

Cardiac Imaging Techniques; Coronary Artery Disease (diagnostic imaging, ethnology); Diabetes Complications (diagnostic imaging, ethnology); Healthcare Disparities; Humans; Sex Factors; Tomography, X-Ray Computed; Vitamin D Deficiency (complications, ethnology)

PubMed ID

30520779

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