142nd APHA Annual Meeting and Exposition

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Carotid Intima Media Thickness and low HDL in South Asian immigrants: Could Dysfunctional HDL be the missing link?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:30 PM - 1:45 PM

Sunita Dodani, M.B.B.S (MD), FCPS, MSc, Ph.D. , Cardiology Divison, Department of Internal Medicine, College of Medicine, University of Florida., University of Florida, Jacskonville, FL
Lei Dong, MS , Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS
Srinivasa Reddy, Professor , Medicine, University of California Los Angeles, Los Angeles, CA
South Asian immigrants (SAIs) in the US exhibit higher prevalence of coronary artery disease (CAD) and its risk factors compared with other ethnic populations. Conventional CAD risk factors do not explain excess CAD risk; therefore there is a need to identify other markers that can predict future risk of CAD in high risk SAIs. The objective of the current study is to assess the presence of sub-clinical CAD using common carotid artery intima-media thickness (CCA-IMT), its association with metabolic syndrome (MS) and pro-inflammatory/Dysfunctional HDL (Dys-HDL). Materials & Methods:  A community-based study was conducted on 130 first generation SAIs aged 35–65 years. Dys-HDL was determined using HDL inflammatory index. Analysis was completed using logistic regression and Fisher-Exact test. Results: Sub-clinical CAD using CCA-IMT ≥ 0.8 mm (as a surrogate marker) was seen in 31.46%%. Age and gender adjusted CCA-IMT was significantly associated with type 2 diabetes (p=0.008), hypertension (p=0.012), high-sensitivity C-reactive protein (p<0.001) and Homocysteine (p=0.051). Both the presence of MS and Dys-HDL was significantly correlated with CCA-IMT, even after age and gender adjustment. The odds of having Dys-HDL with CCA-IMT were 5 times (95% CI: 1.68, 10.78) than those without Dys-HDL. Conclusion: There is need to explore and understand non-traditional CAD risk factors with special focus on Dys-HDL, knowing that SAIs have low HDL levels. This information will not only help to stratify high risk asymptomatic SAI groups, but will also be useful from a disease management point of view

Learning Areas:


Learning Objectives:
Identify the association of sub-clinical Coronary Artery Disease (CAD)using common carotid artery intima-media thickness as a surrogate marker of atherosclerosis in South Asian Immigrants with dysfunctional HDL and other CAD risk factors

Keyword(s): Asian and Pacific Islanders, Heart Disease

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm a trained epidemiologist and PI of the current study that is funded by the NIH. My research expertise are focused on health disparities related to cardiovascular diseases, dyslipidemias and type 2 diabetes in South Asians. This high-risk group has highest prevalence of coronary artery disease (CAD) and dyslipidemias play a major role in causing CAD. We assessed the association of dysfunctional HDL (novel marker) and sub-clinical CAD for better risk stratification in this population.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4223.0: Chronic Disease Epidemiology