Literature DB >> 11944758

Risk factors, hospital management and outcomes after acute myocardial infarction in South Asian Canadians and matched control subjects.

Milan Gupta1, Anand V Doobay, Narendra Singh, Sonia S Anand, Faisal Raja, Fazeelat Mawji, Julian Kho, Alice Karavetian, Qilong Yi, Salim Yusuf.   

Abstract

BACKGROUND: Coronary artery disease affects a significantly larger proportion of Canadians of South Asian origin than Canadians of other ethnic origins. We compared differences in presentation, risk factors and management of myocardial infarction (MI) between South Asian Canadians and matched control subjects.
METHODS: We reviewed the charts of 553 South Asian patients and 553 non-South Asian matched control subjects presenting with acute MI (International Classification of Diseases code 410) to 2 hospitals in Canada from January 1994 to April 1999. We identified South Asian subjects by their surnames and first names, and by using self-reported ethnicity and country of birth when available. Patients of Southeast Asian and Middle Eastern origin were excluded. The remaining patients were classified as non-South Asian. Subjects were matched by age within 5 years, sex, discharge date within 6 months and hospital of admission. Presentation characteristics, risk factors and major complications were compared between the 2 groups.
RESULTS: The median time from symptom onset to presentation with acute MI was significantly longer among the South Asian subjects than among the control subjects (3.92 v. 3.08 hours) (p = 0.04). The South Asians were more likely than the control subjects to have diabetes mellitus (43.4% v. 28.2%) (p < 0.001) despite having a significantly lower mean body mass index (25.7 v. 28.0) (p = 0.05) but were less likely to have hyperlipidemia (36.2% v. 42.7%, p = 0.05), to smoke (29.3% v. 67.8%) (p < 0.001) or to have pre-existing vascular disease (49.4% v. 55.0%, p = 0.04). Treatment of acute MI was similar between the South Asian and matched control groups. Also similar were the in-hospital outcomes, including mortality (9.6% and 7.8%, p = 0.27).
INTERPRETATION: There are clear differences in the risk factor profile between Canadians of South Asian origin and those of non-South Asian origin who have acute MI. Despite the higher incidence of cardiovascular disease in the South Asian population, our results indicate that the in-hospital case-fatality rate for MI is the same for South Asian and non-South Asian Canadians.

Entities:  

Mesh:

Year:  2002        PMID: 11944758      PMCID: PMC99450     

Source DB:  PubMed          Journal:  CMAJ        ISSN: 0820-3946            Impact factor:   8.262


  17 in total

1.  Coronary Artery Disease in Asian Indians: Prevalence and Risk Factors.

Authors:  Prabhat Jha; Enas Enas; Salim Yusuf
Journal:  Asian Am Pac Isl J Health       Date:  1993

Review 2.  Canadian Consensus Conference on Coronary Thrombolysis. Recommendations.

Authors: 
Journal:  Can J Cardiol       Date:  1993 Jul-Aug       Impact factor: 5.223

3.  Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths.

Authors:  T Sheth; C Nair; M Nargundkar; S Anand; S Yusuf
Journal:  CMAJ       Date:  1999-07-27       Impact factor: 8.262

4.  Disturbances of insulin in British Asian and white men surviving myocardial infarction.

Authors:  L O Hughes; J K Cruickshank; J Wright; E B Raftery
Journal:  BMJ       Date:  1989-08-26

5.  Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE)

Authors:  S S Anand; S Yusuf; V Vuksan; S Devanesen; K K Teo; P A Montague; L Kelemen; C Yi; E Lonn; H Gerstein; R A Hegele; M McQueen
Journal:  Lancet       Date:  2000-07-22       Impact factor: 79.321

6.  Insulin resistance, diabetes, and risk markers for ischaemic heart disease in Asian men and non-Asian in Bradford.

Authors:  T M Knight; Z Smith; A Whittles; P Sahota; J A Lockton; G Hogg; A Bedford; M Toop; E E Kernohan; M R Baker
Journal:  Br Heart J       Date:  1992-05

7.  Angiographic comparison of coronary artery disease between Asians and Caucasians.

Authors:  J Dhawan; C L Bray
Journal:  Postgrad Med J       Date:  1994-09       Impact factor: 2.401

8.  The Study of Health Assessment and Risk in Ethnic groups (SHARE): rationale and design. The SHARE Investigators.

Authors:  S S Anand; S Yusuf; V Vuksan; S Devanesen; P Montague; L Kelemen; J Bosch; C Sigouin; K K Teo; E Lonn; H C Gerstein; R A Hegele; M McQueen
Journal:  Can J Cardiol       Date:  1998-11       Impact factor: 5.223

9.  Insulin resistance, high prevalence of diabetes, and cardiovascular risk in immigrant Asians. Genetic or environmental effect?

Authors:  J Dhawan; C L Bray; R Warburton; D S Ghambhir; J Morris
Journal:  Br Heart J       Date:  1994-11

10.  Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians.

Authors:  P M McKeigue; B Shah; M G Marmot
Journal:  Lancet       Date:  1991-02-16       Impact factor: 79.321

View more
  32 in total

1.  Diversity in cardiovascular outcomes among Chinese and South Asian patients.

Authors:  John Z Ayanian
Journal:  Circulation       Date:  2010-10-04       Impact factor: 29.690

2.  Invasive cardiac procedure use and mortality among South Asian and Chinese Canadians with coronary artery disease.

Authors:  Hude Quan; Nadia Khan; Bing Li; Karin H Humphries; Peter Faris; P Diane Galbraith; Michelle Graham; Merril L Knudtson; William A Ghali
Journal:  Can J Cardiol       Date:  2010 Aug-Sep       Impact factor: 5.223

Review 3.  Managing cardiovascular risk in minority patients.

Authors:  Keith C Ferdinand
Journal:  J Natl Med Assoc       Date:  2005-04       Impact factor: 1.798

4.  Myocardial infarction in South Asians.

Authors:  Vivian S Rambihar
Journal:  CMAJ       Date:  2002-09-03       Impact factor: 8.262

5.  Prevalence of metabolic syndrome and associated risk factors in Asian Indians.

Authors:  Ajay Balasubramanyam; Shaun Rao; Ranjita Misra; Rajagopal V Sekhar; Christie M Ballantyne
Journal:  J Immigr Minor Health       Date:  2008-08

Review 6.  Is South Asian ethnicity an independent cardiovascular risk factor?

Authors:  Milan Gupta; Stephanie Brister
Journal:  Can J Cardiol       Date:  2006-03-01       Impact factor: 5.223

7.  Living with Diabetes: Personal Interviews with Pakistani Women in Norway.

Authors:  Walaa Abuelmagd; Helle Håkonsen; Khadijah Qurrat-Ul-Ain Mahmood; Najmeh Taghizadeh; Else-Lydia Toverud
Journal:  J Immigr Minor Health       Date:  2018-08

Review 8.  Metabolic syndrome and cardiovascular disease in South Asians.

Authors:  Danny Eapen; Girish L Kalra; Nadya Merchant; Anjali Arora; Bobby V Khan
Journal:  Vasc Health Risk Manag       Date:  2009-09-07

9.  Country of birth and survival after a first myocardial infarction in Stockholm, Sweden.

Authors:  Ebba Hedlund; Kenneth Pehrsson; Anders Lange; Niklas Hammar
Journal:  Eur J Epidemiol       Date:  2008       Impact factor: 8.082

10.  Outcomes in a diabetic population of South Asians and whites following hospitalization for acute myocardial infarction: a retrospective cohort study.

Authors:  Aman P K Nijjar; Hong Wang; Kaberi Dasgupta; Doreen M Rabi; Hude Quan; Nadia A Khan
Journal:  Cardiovasc Diabetol       Date:  2010-01-22       Impact factor: 9.951

View more

北京卡尤迪生物科技股份有限公司 © 2022-2023.