OBJECTIVES: To compare mortality and factors predictive for outcome in age matched white and South Asian cohorts after first admission for heart failure. DESIGN: Matched historical cohort study. SETTING: One National Health Service trust comprising three acute care hospitals. PARTICIPANTS: 176 South Asian (mean age 68 (10) years, 45% women) and 352 age and sex matched white (70 (11) years, 42% women) patients hospitalised for the first time with heart failure. MAIN OUTCOME MEASURES: All cause survival, measures of disease severity, and the association of clinical variables with outcome. RESULTS: Compared with white patients, South Asian patients had similar rates of prior coronary heart disease but more often had prior hypertension (45% v 33%, p = 0.006) and diabetes (46% v 18%, p < 0.0001). Atrial fibrillation (15% v 31%, p = 0.0002) and prior diuretic use (39% v 48%, p = 0.041) were less common among South Asians. Left ventricular function was more often preserved (38% v 23%, p = 0.002) and less often severely impaired (18% v 28%, p = 0.025) among South Asians. During follow up (range 520-1880 days) 73 of 176 (41.2%) South Asian and 167 of 352 (47.4%) white patients died. South Asian ethnicity was associated with lower all cause mortality (odds ratio 0.71, 95% confidence interval 0.53 to 0.96, p = 0.02). Other predictors of outcome (admission age, lower systolic blood pressure, higher creatinine, higher plasma glucose, and lower haemoglobin) were similar in each cohort. CONCLUSIONS: At first hospitalisation, heart failure appears less advanced in South Asians, among whom diabetes and hypertension are more prevalent. Survival is better for South Asian than for white patients. Higher glucose and lower haemoglobin at admission provide useful prognostic information in heart failure.
OBJECTIVES: To compare mortality and factors predictive for outcome in age matched white and South Asian cohorts after first admission for heart failure. DESIGN: Matched historical cohort study. SETTING: One National Health Service trust comprising three acute care hospitals. PARTICIPANTS: 176 South Asian (mean age 68 (10) years, 45% women) and 352 age and sex matched white (70 (11) years, 42% women) patients hospitalised for the first time with heart failure. MAIN OUTCOME MEASURES: All cause survival, measures of disease severity, and the association of clinical variables with outcome. RESULTS: Compared with white patients, South Asian patients had similar rates of prior coronary heart disease but more often had prior hypertension (45% v 33%, p = 0.006) and diabetes (46% v 18%, p < 0.0001). Atrial fibrillation (15% v 31%, p = 0.0002) and prior diuretic use (39% v 48%, p = 0.041) were less common among South Asians. Left ventricular function was more often preserved (38% v 23%, p = 0.002) and less often severely impaired (18% v 28%, p = 0.025) among South Asians. During follow up (range 520-1880 days) 73 of 176 (41.2%) South Asian and 167 of 352 (47.4%) white patients died. South Asian ethnicity was associated with lower all cause mortality (odds ratio 0.71, 95% confidence interval 0.53 to 0.96, p = 0.02). Other predictors of outcome (admission age, lower systolic blood pressure, higher creatinine, higher plasma glucose, and lower haemoglobin) were similar in each cohort. CONCLUSIONS: At first hospitalisation, heart failure appears less advanced in South Asians, among whom diabetes and hypertension are more prevalent. Survival is better for South Asian than for white patients. Higher glucose and lower haemoglobin at admission provide useful prognostic information in heart failure.
Authors: Eugene Braunwald; Michael J Domanski; Sarah E Fowler; Nancy L Geller; Bernard J Gersh; Judith Hsia; Marc A Pfeffer; Madeline M Rice; Yves D Rosenberg; Jean L Rouleau Journal: N Engl J Med Date: 2004-11-07 Impact factor: 91.245
Authors: William M McClellan; W Dana Flanders; Robert D Langston; Claudine Jurkovitz; Rodney Presley Journal: J Am Soc Nephrol Date: 2002-07 Impact factor: 10.121
Authors: Milton Packer; Michael B Fowler; Ellen B Roecker; Andrew J S Coats; Hugo A Katus; Henry Krum; Paul Mohacsi; Jean L Rouleau; Michal Tendera; Christoph Staiger; Terry L Holcslaw; Ildiko Amann-Zalan; David L DeMets Journal: Circulation Date: 2002-10-22 Impact factor: 29.690
Authors: Jonathan G Howlett; Robert S McKelvie; Jeannine Costigan; Anique Ducharme; Estrellita Estrella-Holder; Justin A Ezekowitz; Nadia Giannetti; Haissam Haddad; George A Heckman; Anthony M Herd; Debra Isaac; Simon Kouz; Kori Leblanc; Peter Liu; Elizabeth Mann; Gordon W Moe; Eileen O'Meara; Miroslav Rajda; Samuel Siu; Paul Stolee; Elizabeth Swiggum; Shelley Zeiroth Journal: Can J Cardiol Date: 2010-04 Impact factor: 5.223
Authors: Paramjit S Gill; Melanie Calvert; Russell Davis; Michael K Davies; Nick Freemantle; Gregory Y H Lip Journal: PLoS One Date: 2011-11-16 Impact factor: 3.240