Case fatality rates for South Asian and Caucasian patients show no difference 2.5 years after percutaneous coronary intervention

Jones, Daniel A.; Rathod, Krishnaraj S.; Junghans, Cornelia; Gallagher, Sean; Rothman, Martin T.; Mohiddin, Saidi A.; Kapur, Amit; Knight, C. E.; Archbold, Andrew; Jain, Ajay; Mills, Peter; Uppal, Rakesh; Mathur, Ashish; Wragg, Andrew

doi:10.1136/heartjnl-2011-300130

Cited by 20 publications

(18 citation statements)

References 24 publications

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“…Bhopal, Scottish Health and Ethnicity Linkage Study). Using a similar study design with routinely collected hospital administrative data linked to cardiac procedure registries from British Columbia and the Calgary health region area in Alberta, Canada, Khan et al 14 reported that south Asian patients had a lower relative risk of long-term mortality compared with white patients (hazard ratio 0.65; 95% CI 0.57 to 0.72), while in-hospital and longer-term mortality of south Asians appeared no worse than that of Caucasians in a study of 9771 patients who underwent percutaneous coronary intervention in a London teaching hospital serving a large south Asian community (18.5% were south Asian, with diabetes being far more prevalent in south Asians at 45.9±1.2% vs 15.7±0.4%, p<0.0001 in Caucasians) 15. These new studies have contradicted some earlier reports, but it looks like the outcome after presentation with coronary disease is not worse in south Asians in spite of their high prevalence of diabetes.…”

Section: Is the High Rate Of Coronary Mortality In South Asians A Resmentioning

confidence: 95%

New answers to three questions on the epidemic of coronary mortality in south Asians: incidence or case fatality? Biology or environment? Will the next generation be affected?

Zaman

Bhopal

2012

Heart

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Studying ethnic differences in health not only benefits minority groups but is a powerful tool for scientific analysis and for social action in the wider field of health inequalities. Coronary mortality in developed countries is well-known to be higher for men and women born in south Asia compared to other ethnic groups. The aim of this review is to examine how the knowledge of ethnic differences in coronary health in south Asians has advanced in the last decade. We set out to answer the following: Is the high rate of coronary mortality in south Asians a result of high incidence or high case fatality? Why are there ethnic differences, and are they the result of biology, healthcare or social circumstances? Is the cardiovascular health future for south Asians (and especially the UK-born second generation) any brighter than in their parents?

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Section: Is the High Rate Of Coronary Mortality In South Asians A Resmentioning

confidence: 95%

New answers to three questions on the epidemic of coronary mortality in south Asians: incidence or case fatality? Biology or environment? Will the next generation be affected?

Zaman

Bhopal

2012

Heart

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“…7,27,55-57 However, short-7-9,27,32,55,58 and long-term mortality 7,27,31,32,34,51 after MI appeared to be similar among South Asian and white people (Appendix 3).…”

Section: Diagnosis Management and Outcomesmentioning

confidence: 97%

“…were more likely to have hypertension compared with white people 3,4,9,14,27,28,31,32,[34][35][36]41,44 (OR 1.11, 95% CI 1.02 to 1.22, p = 0.02).…”

Section: Cmaj Openmentioning

confidence: 99%

“…Once in hospital, however, South Asian people and white people had similar access to diagnostic procedures and interventions 2,7,8,27 for CVD, although there was some practice and outcome variation between provinces (Appendix 3). Following hospital admission for acute coronary syndrome, South Asians had higher short-term (< 1 yr) recurrent event rates, including readmission to hospital and recurrent angina, compared with white people.7,27,55-57 However, short-7-9,27,32,55,58 and long-term mortality 7,27,31,32,34,51 after MI appeared to be similar among South Asian and white people (Appendix 3). …”

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confidence: 99%

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Cardiovascular risk among South Asians living in Canada: a systematic review and meta-analysis

et al. 2014

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Background: South Asians represent about 3% of the Canadian population and have a higher burden of certain cardiovascular risk factors and cardiovascular disease (CVD) compared with white people. The objective of this study was to review the literature to compare cardiovascular risk factors and disease management practices among adult South Asian and white Canadians. Methods:We searched MEDLINE, Embase, Cochrane and Cumulative Index to Nursing and Allied Health Literature databases from their inception through Feb. 17, 2014 and the reference lists of the selected articles. English-language studies of interventions and observational studies of biological mechanisms underlying CVD risk in South Asians conducted in Canada were eligible for inclusion. Where appropriate, we used random-effects meta-analyses to integrate results comparing the CVD risk profiles of South Asian and white Canadians. Results:We included 50 articles (n = 5 805 313 individuals) in this review. Compared with white Canadians, South Asian Canadians had a higher prevalence and incidence of CVD, an increased prevalence of diabetes (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.81 to 2.80, p < 0.001) and hypertension (OR 1.11, 95% CI 1.02 to 1.22, p = 0.02), lower high-density lipoprotein cholesterol levels (mean difference -0.19 mmol/L, 95% CI -0.25 to -0.13 mmol/L, p < 0.001) and a higher percentage of body fat (men: absolute mean difference 3.23%, 95% CI 0.83% to 5.62%, p = 0.008; women: absolute mean difference 4.09%, 95% CI 3.46% to 4.72%, p < 0.001). South Asian people are also more sedentary, consume higher levels of carbohydrates and are less likely to smoke tobacco (OR 0.38, 95% CI 0.24 to 0.60, p < 0.001]) than white Canadians. No differences in access to diagnostic tests, outcomes following cardiovascular surgery or use of cardiac rehabilitation programs were apparent.Interpretation: Compared with white people, South Asian people living in Canada have a higher prevalence and incidence of CVD and possess a unique cardiovascular risk profile. Abstract E184CMAJ OPEN, 2(3) Research CMAJ OPEN Methods Search strategy and selectionIn consultation with an information specialist, we developed search terms for MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane Registry databases to identify human studies reporting associations among South Asian ethnicity, CVD risk factors and CVD. The initial search (conducted May 21, 2013) captured articles from database inception through May 2013; at the request of the CMAJ Open editors, the search was updated through to Feb. 17, 2014 (Appendix 1, available online at www.cmajopen.ca/content/2/3/E183/suppl/DC1). Three investigators (A.R., R.dS. and S.S.A.) each screened a third of the titles and abstracts of the studies identified in the electronic search to arrive at a list of articles for full-text review. The same 3 reviewers assessed the eligibility of these fulltext articles. Disagreements were resolved by discussion and consensus. Studies that were not p...

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“…While some studies have suggested higher case-fatality rates following acute myocardial infarction (AMI) in migrant SA patients compared with White European (WE) patients in the UK,9 10 others from the UK5 11–13 and Canada8 14 have suggested similar11 12 14 15 or better5 8 13 adjusted survival for these ethnic groups in this setting.…”

Section: Introductionmentioning

confidence: 99%

Survival in South Asian and White European patients after acute myocardial infarction

Gholap

Khunti

Davies

et al. 2015

Heart

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Case fatality rates for South Asian and Caucasian patients show no difference 2.5 years after percutaneous coronary intervention

Cited by 20 publications

References 24 publications

New answers to three questions on the epidemic of coronary mortality in south Asians: incidence or case fatality? Biology or environment? Will the next generation be affected?

New answers to three questions on the epidemic of coronary mortality in south Asians: incidence or case fatality? Biology or environment? Will the next generation be affected?

Cardiovascular risk among South Asians living in Canada: a systematic review and meta-analysis

Survival in South Asian and White European patients after acute myocardial infarction

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