Therapeutic Area ASCVD/CVD in Special Populations Background South Asian (SA) individuals are known to have a higher risk of heart disease when compared to Caucasians. The role of coronary artery size in modifying this risk has been debated. Prior angiographic studies using coronary artery diameters showed smaller vessels in SA, whereas studies using cross sectional area from non-contrast Computed Tomography (CT) did not show this difference. Studies assessing volumes by contrast CTA (CT Angiography) in this population are minimal and are limited by small sample size. We aimed to expand on this literature with estimation of coronary artery volumes in a South Asian cohort using CTA. Methods We evaluated total, and vessel specific body surface area (BSA) adjusted coronary artery luminal volumes in 341 South Asian patients receiving clinically indicated CTAs in the DIL wellness and Arterial health Longitudinal Evaluation registry. A separate analysis was performed in patients with no plaque to eliminate any influence of plaque burden on luminal volumes. We then compared the difference in luminal volumes between men and women. All patients received vasodilators as part of the protocol. Vessel volumes were calculated by using a commercially available vessel analysis tool. To compare patient demographics factors, baseline characteristics, and BSA-adjusted lumen volume, Mann Whitney U test or T- test was applied to continuous variables. Chi-square test or Fisher’s exact test was applied to categorical variables. A significance level of 5% was used at all statistical tests stated above. All analyses were performed using R statistical software version 4.4.0. Results Baseline demographics are shown in Table 1. Risk factors were equally distributed between men and women except smoking, which was more common in men. The total lumen volume/BSA was 925 mm3/m2 in all SA and 963mm3/m2 in the subset with no plaque. Individual vessel volumes are demonstrated in Table 1. Total BSA indexed lumen volume was significantly higher in men when compared to women (958 vs 851 mm3/m22; p= 0.005). This was true in the subset without any plaque as well. Compared with prior literature on coronary artery volumes in a smaller cohort of SA, all indexed volumes appeared smaller in our study (Total 1434 mm3/m2 vs 925 mm2/m3). The volumes were also smaller when compared with data on Caucasians in this study. Conclusions Our study provides a comprehensive assessment of coronary artery luminal volumes in a South Asian cohort using CT angiography (CTA). The assessment of CT derived coronary volumes in patients with and without plaque expands on previous literature from angiographic and non-contrast CT studies. Future investigations in larger cohorts of SA should include assessment of coronary artery volumes indexed to myocardial mass to improve prognostication.
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