ArticleAtherosclerosis2021
Implications of the 2019 American College of Cardiology/American Heart Association Primary Prevention Guidelines and potential value of the coronary artery calcium score among South Asians in the US: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.
Article in Atherosclerosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Rethinking the coronary artery calcium scan: from population averages to individual realities - visualizing subclinical risk in South Asian adults.American journal of preventive cardiology · 2026Article
- Coronary Plaque Burden in South Asian Adults: Insights From the DILWALE Registry.JACC. Advances · 2026Article
- South Asian Cardiovascular Risk: Role of Coronary Artery Calcium Scoring and Computed Tomography Angiography.JACC. Asia · 2026Review
- Validating clinical risk scores in contemporary populations using CCTA.American journal of preventive cardiology · 2026Article
- Cardiovascular Disease Risk in South Asians in the Baylor Scott and White Health DILWALE Registry.JACC. Advances · 2024Article
- Association of cardiovascular health with subclinical coronary atherosclerosis progression among five racial and ethnic groups: The MASALA and MESA studies.Atherosclerosis · 2024Article
- The Pandemic of Coronary Heart Disease in South Asia: What Clinicians Need to Know.Current atherosclerosis reports · 2023Review
- Identification and Management of Atherosclerotic Cardiovascular Disease Risk in South Asian Populations in the U.S.JACC. Advances · 2023Article
- Leveling the playing field: The utility of coronary artery calcium scoring in cardiovascular risk stratification in South Asians.American journal of preventive cardiology · 2023Review
- A Message From the Next Generations: I Believe in You-Take Control of Your Health.JACC. Advances · 2023Article
- Toward Understanding Cardiovascular Risk Burden in South Asians: A Major Step Forward.JACC. Asia · 2022Article
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Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
Abstract
BACKGROUND AND
aimsSouth Asian (SA) ethnicity is associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). However, the implications of considering SA ethnicity as a "risk-enhancing factor" per recent American College of Cardiology/American Heart Association guidelines are not fully understood.
methodsWe used data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, a community-based cohort study of individuals of SA ancestry living in the US. The Pooled Cohort Equations were used to estimate 10-year ASCVD risk. Metabolic risk factors and coronary artery calcium (CAC) scores were assessed.
resultsAmong 1114 MASALA participants included (median age 56 years, 48% women), 28% were already using a statin at baseline, 25% had prevalent diabetes, and 59% qualified for 10-year ASCVD risk assessment for statin allocation purposes. The prevalence of low, borderline, intermediate, and high estimated ASCVD risk was 65%, 11%, 20% and 5%, respectively. Among participants at intermediate risk, 30% had CAC = 0 and 37% had CAC>100, while among participants at borderline risk, 54% had CAC = 0 and 13% had CAC>100. Systematic consideration of intermediate and, particularly, of borderline risk individuals as statin candidates would enrich the statin-consideration group with CAC = 0 participants up to 35%. Prediabetes and abdominal obesity were highly prevalent across all estimated risk strata, including among those with CAC = 0.
conclusionsOur findings suggest that systematic consideration of borderline risk SAs as statin candidates might result in considerable overtreatment, and further risk assessment with CAC may help better personalize statin allocation in these individuals. Early, aggressive lifestyle interventions aimed at reducing the risk of incident diabetes should be strongly recommended in US SAs, particularly among those considered candidates for statin therapy for primary prevention. Longitudinal studies are needed to confirm the favorable prognosis of CAC = 0 in SAs.
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