Clinical Research Coronary Artery Disease in French CanadiansdInvestigation of a Suggested Vulnerable Population Chadi Ayoub, MBBS, FRACP, FSCCT, a,b Jordan Bernick, MSC, c Punitha Arasaratnam, MBChB, MRCP, a Jonathan D.H. Chow, a Alomgir Hossain, PhD, c Terrence Ruddy, MD, FRCPC, FACC, a,d Graham S. Hillis, PhD, FRCP, b,e Leonard Kritharides, MBBS, PhD, FRACP, FAHA, b,f and Benjamin J.W. Chow, MD, FRCPC, FACC, FASNC, FSCCT a,f a Department of Medicine (Cardiology), University of Ottawa Heart Institute, Ottawa, Ontario, Canada b University of Sydney, New South Wales, Australia c Cardiovascular Research Methods Centre University of Ottawa Heart Institute, Ottawa, Ontario, Canada d Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada e Department of Cardiology, Royal Perth Hospital, University of Western Australia, Perth, Australia f Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada ABSTRACT Background: There is a perception among Canadian physicians that coronary artery disease (CAD) and adverse cardiac events are more common in those of French Canadian heritage. We sought to compare the prevalence of CAD using coronary computed tomographic angi- ography (CCTA) in French Canadians and non-French white Canadians. Methods: Consecutive patients were prospectively enrolled in our institutional CCTA registry. Of 10,868 CCTA examinations, we analyzed white patients who identified themselves as French Canadian or non- French Canadian. These 2 groups were compared for baseline char- acteristics, cardiovascular risk factors, and routine markers for CAD on CTCA. Propensity score adjustments were also made to account for differences in demographics. Results: We identified 1683 French Canadians (mean age, 58.5  10.7 years; 54.2% men) and 5077 non-French white Canadians (mean R  ESUM  E Introduction : De nombreux m edecins canadiens pensent que la coronaropathie et les  ev enements ind esirables de nature cardiaque sont plus fr equents chez les personnes d’ascendance canadienne française. Nous avons compar e la pr evalence de coronaropathie entre des Canadiens français et des canadiens blancs non français à l’aide de la coronarographie par tomodensitom etrie. M ethodes : Les patients ont  et es electionn es cons ecutivement et de manière prospective à partir du registre de coronarographie par tomodensitom etrie de l’ etablissement. À partir des 10 868 examens r ealis es, nous avons compar e les patients blancs qui se sont identifi es comme des Canadiens français ou des Canadiens non français. Nous avons compar e les caract eristiques initiales de même que les facteurs de risque cardiovasculaires et les marqueurs habituels de coro- naropathie des deux groupes. Les coefficients de propension ont  et e There is a perception among Canadian physicians that coro- nary artery disease (CAD) and adverse cardiac events are more prevalent in those of French Canadian heritage. This belief results from higher rates of acute myocardial infarction (AMI) in Quebec and a higher prevalence of risk factors in this population. 1-3 Additionally, there are numerous publications in the medical literature describing clusters of familial hy- percholesterolemia (FH) in French Canadians, who are considered to be a “founder population.” 4-7 This may have further lent weight to the widespread belief of a higher CAD risk, prevalence, and associated complications. Coronary computed tomographic angiography (CCTA) is a widely available noninvasive imaging modality that has the ability to detect and quantify coronary atherosclerosis; it also has prognostic value. 8-11 Cardiac computed tomography (CT) has been used previously to assess coronary atherosclerosis in different ethnic subpopulations, including ethnic minorities in Canadian Journal of Cardiology - (2016) 1e6 Received for publication September 14, 2015. Accepted November 6, 2015. Corresponding author: Dr Benjamin J.W. Chow, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada. Tel.: þ1-613-761-4044; fax: þ1-613-761-4929. E-mail: bchow@ottawaheart.ca See page 5 for disclosure information. http://dx.doi.org/10.1016/j.cjca.2015.11.006 0828-282X/Ó 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.