Differences in coronary plaque morphology between East Asian and Western White patients: an optical coherence tomography study

Aims Prevalence of coronary artery disease as well as cardiac mortality varies between Asian and White patients. However, the link between race and plaque characteristics in patients with coronary artery disease remains largely unexplored. Thus, we aimed to investigate the detailed culprit plaque characteristics between East Asian and White patients using optical coherence tomography. Patients and methods A total of 101 East Asians were matched to 101 White patients. Matching parameters included age, sex, clinical presentation, hyperlipidemia, diabetes mellitus, and lesion location. Results There were no differences in underlying pathology (rupture vs. erosion) of acute coronary syndrome (P=0.935). Lesion length was longer (18.0 +/- 6.0 vs. 14.6 +/- 5.4 mm; P<0.002), lipid length was greater (9.4 +/- 4.6 vs. 7.2 +/- 3.8 mm; P<0.023), lipid index was higher (1635 +/- 987 vs. 1104 +/- 730; P=0.002), and mean reference area was larger (8.1 +/- 3.0 vs. 6.5 +/- 2.4 mm(2); P<0.021) in White patients compared with East Asian patients. Conclusion There are significant differences in plaque morphology between East Asian and White patients even after controlling for confounders. Our findings underscore key differences in atherosclerosis between East Asian and White populations, and may have to be taken into consideration when interpreting the results of future research. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.