Dr. Khurram Nasir, chief of the Houston Methodist Cardiovascular Prevention and Wellness Division, presents novel findings from the Miami Heart Study, the first cohort study in the U.S. to conduct coronary computed tomography angiography (CCTA) assessment in a large population of asymptomatic individuals drawn from the general population.

The Miami Heart Study kicked off in 2015, enrolling nearly 2,500 volunteers from the Greater Miami Area aged 40-65. The cohort included a significant proportion of Hispanics (47%), a large and rapidly expanding portion of the population in the U.S., often underrepresented in cardiovascular studies.

Participants underwent a detailed baseline assessment including coronary artery calcium (CAC) scoring, CCTA scanning and a host of additional blood and vascular biomarkers.

"We've learned a lot about the risk factors that lead to coronary heart disease events over the past 50 years," says co-author Dr. Javier Valero-Elizondo. "This has led to increased interest in gaining a better understanding of the biology and determinants of subclinical coronary disease, when patients don't have symptoms or problems yet, but the disease process has already started."

According to principal investigator Dr. Nasir, preventing the onset of coronary atherosclerosis and targeting individuals who already have developed subclinical disease with intensive preventive interventions are important areas of innovation in preventive cardiology. The Miami Heart Study will be key to informing contemporary primary prevention interventions, as well as enhanced risk stratification approaches in younger-to-middle-aged U.S. adults.

Dr. Nasir will present the most recent Miami Heart results, examining the association between sex-specific hormones with high-risk coronary artery plaque in women, at the American College of Cardiology Conference in April 2022.

A previous Miami Heart study showed a significant burden of coronary plaque in the general U.S. population, suggesting a need for more intensive cardiovascular prevention in the U.S.

However, among those with a CAC score of zero, severe coronary stenosis and high-risk plaque remain very rare findings. Current guidelines support a more flexible preventive management among individuals with CAC score of zero, with Miami Heart findings providing further support for the recommendation.