Inflammation and coronary artery calcification in South Asians

The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study

Anurag Mehta, Jaideep Patel, Mahmoud Al Rifai, Colby R. Ayers, Ian J. Neeland, Alka M. Kanaya, Namratha R Kandula, Michael J. Blaha, Khurram Nasir, Roger S. Blumenthal, Parag H. Joshi

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)49-56
Number of pages8
JournalAtherosclerosis
Volume270
DOIs
StatePublished - Mar 1 2018

Fingerprint

Adipokines
Atherosclerosis
Coronary Vessels
Biomarkers
Inflammation
Calcium
Adiponectin
Leptin
C-Reactive Protein
Tumor Necrosis Factor-alpha
Logistic Models
Blood Vessels

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Mehta, Anurag ; Patel, Jaideep ; Al Rifai, Mahmoud ; Ayers, Colby R. ; Neeland, Ian J. ; Kanaya, Alka M. ; Kandula, Namratha R ; Blaha, Michael J. ; Nasir, Khurram ; Blumenthal, Roger S. ; Joshi, Parag H. / Inflammation and coronary artery calcification in South Asians : The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. In: Atherosclerosis. 2018 ; Vol. 270. pp. 49-56.
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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.",
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Inflammation and coronary artery calcification in South Asians : The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. / Mehta, Anurag; Patel, Jaideep; Al Rifai, Mahmoud; Ayers, Colby R.; Neeland, Ian J.; Kanaya, Alka M.; Kandula, Namratha R; Blaha, Michael J.; Nasir, Khurram; Blumenthal, Roger S.; Joshi, Parag H.

In: Atherosclerosis, Vol. 270, 01.03.2018, p. 49-56.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Inflammation and coronary artery calcification in South Asians

T2 - The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study

AU - Mehta, Anurag

AU - Patel, Jaideep

AU - Al Rifai, Mahmoud

AU - Ayers, Colby R.

AU - Neeland, Ian J.

AU - Kanaya, Alka M.

AU - Kandula, Namratha R

AU - Blaha, Michael J.

AU - Nasir, Khurram

AU - Blumenthal, Roger S.

AU - Joshi, Parag H.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - 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.

AB - 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.

KW - Biomarker

KW - Coronary artery calcium

KW - Inflammation

KW - Prevention

KW - South Asian

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