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Atherosclerosis. 2018 Mar;270:49-56. doi: 10.1016/j.atherosclerosis.2018.01.033. Epub 2018 Jan 31.

Inflammation and coronary artery calcification in South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.

Author information

1
Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
2
The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, United States; Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, United States.
3
The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, United States; Department of Medicine, University of Kansas School of Medicine, Wichita, KS, United States.
4
Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, TX, United States.
5
Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States.
6
Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.
7
Department of Medicine, Northwestern University, Chicago, IL, United States.
8
The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, United States.
9
The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, United States; Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, United States; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States.
10
The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, United States; Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States. Electronic address: Parag.Joshi@utsouthwestern.edu.

Abstract

BACKGROUND AND AIMS:

Inflammatory biomarkers and adipocytokines (IBA) may contribute to atherosclerosis by promoting vascular inflammation. The association between IBA and coronary artery calcium (CAC), a marker of subclinical atherosclerosis, is not well defined in South Asians (SA). We hypothesized that IBA (high sensitivity C-reactive protein [hsCRP], tumor necrosis factor alpha [TNF-α], adiponectin, and leptin) were independently associated with and improved discrimination of CAC among SA.

METHODS:

We analyzed IBA and CAC among participants in the prospective Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. We used logistic regression models to examine cross-sectional associations of IBA with CAC presence (CAC >0) and severity (CAC >100), and C-statistics to assess the incremental contribution of each IBA to traditional risk factors (TRF) from the AHA/ACC Pooled Cohort Equations (PCE) for discrimination of CAC.

RESULTS:

Among 906 participants in the MASALA study, women (n = 420) had significantly higher levels of hsCRP, adiponectin, and leptin but lower levels of TNF-α than men (p < .01 for all). There was no significant association between any of the four IBA and either CAC category in multivariable-adjusted models, respectively. Lastly, none of the four IBA improved discrimination of CAC presence or severity when added to elements of the PCE.

CONCLUSIONS:

IBA were not associated with CAC presence or severity in the MASALA population. IBA did not help identify SA at risk of subclinical atherosclerosis, although associations with ASCVD events remain unclear. In SA, CAC may have a distinct pathophysiology independent of inflammation as measured by IBA.

KEYWORDS:

Biomarker; Coronary artery calcium; Inflammation; Prevention; South Asian

PMID:
29407888
PMCID:
PMC5835417
[Available on 2019-03-01]
DOI:
10.1016/j.atherosclerosis.2018.01.033

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