Diana Choi1, Edson Nemi2, Carlos Fernando2, Milan Gupta3, Gordon W Moe4. 1. Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 2. Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. 3. Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada; Keenan Research Center in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada. 4. Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Keenan Research Center in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada. Electronic address: moeg@smh.toronto.on.ca.
Abstract
OBJECTIVES: The purpose of our study was to compare the clinical features of Chinese and South Asians, the 2 largest minority populations in Canada, with non-Chinese/non-South Asian (NCH/NSA) patients managed in common social macroenvironments and healthcare systems. BACKGROUND: Heart failure is an increasingly prevalent condition. Although ethnic minorities comprise a growing proportion of the population in Western countries, the clinical profiles of ethnic minorities with heart failure are largely unknown. METHODS: We analyzed records of patients with heart failure managed in 2 specialized clinics in Ontario, Canada. Of the 1,671 patients, 181 (11%) were identified as Chinese and 215 (13%) as South Asian. RESULTS: Our analyses showed that fewer Chinese patients were found to have a history of myocardial infarction (MI) (30% vs. 52%), 3 occluded/stenosed coronary vessels on angiogram (47% vs. 51%), grade 3 or worse left ventricular dysfunction (22% vs. 42%), and a prescription of angiotensin-converting enzyme inhibitors (42% vs. 63%) compared with their NCH/NSA counterparts. In contrast, South Asian patients more frequently had a past history of an MI (70% vs. 52%), 3 occluded/stenosed coronary vessels on angiogram (68% vs. 51%), and treatment with coronary revascularizations (55% vs. 40%) compared with NCH/NSA patients. CONCLUSIONS: Our study demonstrates important differences in comorbid conditions, clinical characteristics, and treatment patterns among Chinese and South Asian patients compared with NCH/NSA patients with heart failure. Awareness of these differences will help to develop differential strategies necessary to prevent and manage heart failure among ethnic minority groups.
OBJECTIVES: The purpose of our study was to compare the clinical features of Chinese and South Asians, the 2 largest minority populations in Canada, with non-Chinese/non-South Asian (NCH/NSA) patients managed in common social macroenvironments and healthcare systems. BACKGROUND:Heart failure is an increasingly prevalent condition. Although ethnic minorities comprise a growing proportion of the population in Western countries, the clinical profiles of ethnic minorities with heart failure are largely unknown. METHODS: We analyzed records of patients with heart failure managed in 2 specialized clinics in Ontario, Canada. Of the 1,671 patients, 181 (11%) were identified as Chinese and 215 (13%) as South Asian. RESULTS: Our analyses showed that fewer Chinese patients were found to have a history of myocardial infarction (MI) (30% vs. 52%), 3 occluded/stenosed coronary vessels on angiogram (47% vs. 51%), grade 3 or worse left ventricular dysfunction (22% vs. 42%), and a prescription of angiotensin-converting enzyme inhibitors (42% vs. 63%) compared with their NCH/NSA counterparts. In contrast, South Asian patients more frequently had a past history of an MI (70% vs. 52%), 3 occluded/stenosed coronary vessels on angiogram (68% vs. 51%), and treatment with coronary revascularizations (55% vs. 40%) compared with NCH/NSA patients. CONCLUSIONS: Our study demonstrates important differences in comorbid conditions, clinical characteristics, and treatment patterns among Chinese and South Asian patients compared with NCH/NSA patients with heart failure. Awareness of these differences will help to develop differential strategies necessary to prevent and manage heart failure among ethnic minority groups.
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