The goal of this project is to fill gaps in our understanding of the antecedents of heart disease in South Asians, specifically focusing on coronary artery calcified plaque. We have established a prospective cohort of South Asians called the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study which is closely tied to the Multi-Ethnic Study of Atherosclerosis (MESA) for efficient cross-ethnic comparisons. We have found that South Asians have significantly higher prevalence of several traditional cardiovascular risk factors, a unique distribution of ectopic body fat deposition, and a high coronary artery calcium burden. We propose to leverage the MASALA cohort baseline data by measuring plaque progression and adding novel measures of coronary plaque to investigate the epidemiology, etiology and natural history of atherosclerotic cardiovascular disease (ASCVD) in South Asians. In this renewal of the MASALA study grant, we propose to determine the progression of coronary plaque by repeating a cardiac computed tomography scan, measure advanced coronary plaque characteristics (calcium density and plaque distribution) from existing baseline scans, and identify the key predictors of ASCVD events among approximately 875 South Asians.
Our aims are to 1) investigate the rate of CAC progression among South Asians after 4 years of follow-up, and compare annualized progression rates to the MESA race/ethnic groups; 2) determine the prevalence and correlates of advanced coronary plaque characteristics among South Asians and compare the prevalence and correlates with the four MESA race/ethnic groups; and 3) determine whether CAC and coronary plaque characteristics are associated with incident myocardial infarction and ASCVD events among South Asians. Studying this high risk ethnic cohort could provide novel insights into the pathogenesis of atherosclerotic disease that cannot be observed in studies focusing on other race/ethnic groups.

Public Health Relevance

South Asians have high rates of heart disease that cannot be explained by traditional cardiovascular risk factors. Coronary artery calcium (CAC) and plaque measured from CT scans can predict heart disease events and provides more information than traditional risk factors. We have established a unique South Asian cohort which has a high burden of CAC and other cardiovascular risk factors. Studying the impact of CAC and other plaque characteristics in this high risk ethnic cohort could provide novel insights into the origin of cardiovascular disease in general.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Special Emphasis Panel (ZRG1)
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Aviles-Santa, Larissa
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Jin, Yichen; DiPietro, Loretta; Kandula, Namratha R et al. (2018) Associations Between Television Viewing and Adiposity Among South Asians. J Racial Ethn Health Disparities 5:1059-1062
Kanaya, Alka M (2018) India's Call to Action-Prioritize Chronic Cardiovascular Disease. JAMA Intern Med 178:373-374
Mehta, Anurag; Patel, Jaideep; Al Rifai, Mahmoud et al. (2018) Inflammation and coronary artery calcification in South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Atherosclerosis 270:49-56
Kandula, Namratha R; Cooper, Andrew J; Schneider, John A et al. (2018) Personal social networks and organizational affiliation of South Asians in the United States. BMC Public Health 18:218
Deol, Rupinder; Lee, Kathryn A; Kandula, Namratha R et al. (2018) Risk of Obstructive Sleep Apnoea is Associated with Glycaemia Status in South Asian Men and Women in the United States. Obes Med 9:1-6
Al Rifai, Mahmoud; Cainzos-Achirica, Miguel; Kanaya, Alka M et al. (2018) Discordance between 10-year cardiovascular risk estimates using the ACC/AHA 2013 estimator and coronary artery calcium in individuals from 5 racial/ethnic groups: Comparing MASALA and MESA. Atherosclerosis 279:122-129
Needham, Belinda L; Mukherjee, Bhramar; Bagchi, Pramita et al. (2018) Acculturation Strategies and Symptoms of Depression: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health 20:792-798
Mongraw-Chaffin, Morgana; Gujral, Unjali P; Kanaya, Alka M et al. (2018) Relation of Ectopic Fat with Atherosclerotic Cardiovascular Disease Risk Score in South Asians Living in the United States (from the Mediators of Atherosclerosis in South Asians Living in America [MASALA] Study). Am J Cardiol 121:315-321
Bharmal, Nazleen H; McCarthy, William J; Gadgil, Meghana D et al. (2018) The Association of Religious Affiliation with Overweight/Obesity Among South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Relig Health 57:33-46
Nadimpalli, Sarah; Keita, Akilah; Wang, Jeremy et al. (2017) Are Experiences of Discrimination Related to Poorer Dietary Intakes Among South Asians in the MASALA Study? J Nutr Educ Behav 49:872-876.e1

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