Coronary plaque prevalence in South Asians

The DILWALE Registry used coronary CT angiography (CCTA) with AI-based quantitative plaque analysis in 341 clinically referred South Asian adults. 63% had detectable coronary plaque, and nearly half of those aged 40–54 already had plaque. About 86% of the plaque was non-calcified. This matters because a conventional coronary calcium (CAC) score measures calcified plaque and does not directly visualize non-calcified plaque. Low-attenuation plaque, a potentially higher-risk plaque type, was found in about 12% of the cohort. There is also a reassuring finding: a CAC score of zero was still associated with low overall plaque burden and rare low-attenuation plaque. These results should not be read as meaning every South Asian needs a CT angiogram. They show that atherosclerosis can begin relatively early, and that in selected high-risk individuals CCTA can give information beyond calcium alone. Bottom line: plaque can start early in South Asians. CCTA is for selected high-risk people, not universal screening. Talk with your doctor about whether CAC or CCTA makes sense for you. Reference: Satish P, Vajramani A, Gupta S, Ma TW, Prasad T, Lakshmanan S, et al. Age and sex specific coronary plaque characteristics among South Asians: Insights from the DILWALE CTA study. American Journal of Preventive Cardiology. 2026;29:101567. doi:10.1016/j.ajpc.2026.101567