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.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL093009-08
Application #
9418516
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Srinivas, Pothur R
Project Start
2008-07-01
Project End
2019-02-28
Budget Start
2018-03-01
Budget End
2019-02-28
Support Year
8
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
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
Talegawkar, Sameera A; Jin, Yichen; Kandula, Namratha R et al. (2017) Cardiovascular health metrics among South Asian adults in the United States: Prevalence and associations with subclinical atherosclerosis. Prev Med 96:79-84
Mongraw-Chaffin, Morgana; Kanaya, Alka M; Kandula, Namratha R et al. (2017) The relationship between anthropometry and body composition from computed tomography: The Mediators of Atherosclerosis in South Asians Living in America Study. Ethn Health 22:565-574
Needham, Belinda L; Mukherjee, Bhramar; Bagchi, Pramita et al. (2017) Acculturation Strategies and Symptoms of Depression: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health :
Gujral, Unjali P; Vittinghoff, Eric; Mongraw-Chaffin, Morgana et al. (2017) Cardiometabolic Abnormalities Among Normal-Weight Persons From Five Racial/Ethnic Groups in the United States: A Cross-sectional Analysis of Two Cohort Studies. Ann Intern Med 166:628-636
Patel, Jaideep; Al Rifai, Mahmoud; Cainzos-Achirica, Miguel et al. (2017) Family History of CHD Is Associated With Severe CAC in South Asians: Comparing the MASALA and MESA Studies. JACC Cardiovasc Imaging 10:958-960
Anand, Shuchi; Kondal, Dimple; Montez-Rath, Maria et al. (2017) Prevalence of chronic kidney disease and risk factors for its progression: A cross-sectional comparison of Indians living in Indian versus U.S. cities. PLoS One 12:e0173554
Gadgil, Meghana D; Oza-Frank, Reena; Kandula, Namratha R et al. (2017) Type 2 diabetes after gestational diabetes mellitus in South Asian women in the United States. Diabetes Metab Res Rev 33:
Needham, Belinda L; Mukherjee, Bhramar; Bagchi, Pramita et al. (2017) Acculturation Strategies Among South Asian Immigrants: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. J Immigr Minor Health 19:373-380
Talegawkar, Sameera A; Kandula, Namratha R; Gadgil, Meghana D et al. (2016) Dietary intakes among South Asian adults differ by length of residence in the USA. Public Health Nutr 19:348-55

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