Ethnic variations in acute coronary syndromes

Lanza, Gaetano Antonio

doi:10.1136/hrt.2003.026476

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…20, No. 1,2013 or W 2 test was used to compare groups as appropriate, and P G 0.05 was considered significant (SigmaStat; Systat Software, Inc., San Jose, CA). Pearson's product moment correlation was used to determine the association between hormone levels and markers of platelet function, cholesterol, and CRP.…”

Section: Discussionmentioning

confidence: 99%

Platelet reactivity and thrombogenicity in postmenopausal women

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Platelet reactivity and thrombogenicity in postmenopausal women

et al. 2013

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“…Studies have shown that CVDs present differently in between ethnic groups [16,17]. Ethnicity has been shown to be an independent predictor of adverse cardiovascular outcomes in patients with atherothrombotic disease [18] and CAD [19].…”

Section: Introductionmentioning

confidence: 99%

“…With CVD accounting for most deaths globally, eliminating ethnic disparities in cardiac care has become a new challenge in the practice of cardiology [ 15 ]. Studies have shown that CVDs present differently in between ethnic groups [ 16 , 17 ]. Ethnicity has been shown to be an independent predictor of adverse cardiovascular outcomes in patients with atherothrombotic disease [ 18 ] and CAD [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010)

Nordin

2013

BMC Cardiovasc Disord

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BackgroundThe National Cardiovascular Disease (NCVD) Database Registry represents one of the first prospective, multi-center registries to treat and prevent coronary artery disease (CAD) in Malaysia. Since ethnicity is an important consideration in the occurrence of acute coronary syndrome (ACS) globally, therefore, we aimed to identify the role of ethnicity in the occurrence of ACS among high-risk groups in the Malaysian population.MethodsThe NCVD involves more than 15 Ministry of Health (MOH) hospitals nationwide, universities and the National Heart Institute and enrolls patients presenting with ACS [ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA)]. We analyzed ethnic differences across socio-demographic characteristics, hospital medications and invasive therapeutic procedures, treatment of STEMI and in-hospital clinical outcomes.ResultsWe enrolled 13,591 patients. The distribution of the NCVD population was as follows: 49.0% Malays, 22.5% Chinese, 23.1% Indians and 5.3% Others (representing other indigenous groups and non-Malaysian nationals). The mean age (SD) of ACS patients at presentation was 59.1 (12.0) years. More than 70% were males. A higher proportion of patients within each ethnic group had more than two coronary risk factors. Malays had higher body mass index (BMI). Chinese had highest rate of hypertension and hyperlipidemia. Indians had higher rate of diabetes mellitus (DM) and family history of premature CAD. Overall, more patients had STEMI than NSTEMI or UA among all ethnic groups. The use of aspirin was more than 94% among all ethnic groups. Utilization rates for elective and emergency percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were low among all ethnic groups. In STEMI, fibrinolysis (streptokinase) appeared to be the dominant treatment options (>70%) for all ethnic groups. In-hospital mortality rates for STEMI across ethnicity ranges from 8.1% to 10.1% (p = 0.35). Among NSTEMI/UA patients, the rate of in-hospital mortality ranges from 3.7% to 6.5% and Malays recorded the highest in-hospital mortality rate compared to other ethnic groups (p = 0.000). In binary multiple logistic regression analysis, differences across ethnicity in the age and sex-adjusted ORs for in-hospital mortality among STEMI patients was not significant; for NSTEMI/UA patients, Chinese [OR 0.71 (95% CI 0.55, 0.91)] and Indians [OR 0.57 (95% CI 0.43, 0.76)] showed significantly lower risk of in-hospital mortality compared to Malays (reference group).ConclusionsRisk factor profiles and ACS stratum were significantly different across ethnicity. Despite disparities in risk factors, clinical presentation, medical treatment and invasive management, ethnic differences in the risk of in-hospital mortality was not significant among STEMI patients. However, Chinese and Indians showed significantly lower risk of in-hospital mortality compared to Malays among NSTEMI and UA patients.

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“…Ethnic differences and varied environmental, lifestyle, cultural, socioeconomics and nutritional factors might explain inconsistent results from different studies. 57,58 In terms of ethnicity, it might be determined by self-reported data, which increases its complication. In some population, individuals are inclined to conceal their main ethnicity and use other ethnicity due to the political or cultural sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Association of GSTP1, GSTT1 and GSTM1 Gene Variants with Coronary Artery Disease in Iranian Population: A Case–Control Study

Pourkeramati

Mehrjardi

Tezerjani³

et al. 2020

IJGM

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Background: Coronary artery disease (CAD) is a multifactorial disease that may be caused by the interaction between environmental and genetic risk factors. Glutathione S-transferases (GSTs) are known to participate in detoxification and metabolism of a wide range of xenobiotic compounds and oxidative stress products. Considering the interaction between environmental and genetic factors in CAD, we investigated the genetic polymorphisms of GSTM1, GSTT1, and GSTP1 in the Iranian population. Patients and Methods: Two hundred and forty-four CAD cases and 281 healthy controls were studied. The genotype of GSTM1, GSTT1, and GSTP1 genes was determined by multiplex polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP) techniques. Multivariable logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CI). Multifactor dimensionality reduction (MDR) analysis was also carried out to analyze the gene-gene and gene-environment interaction.Results: The genotype and allele distribution of the three variations were not significantly different between CAD patients and controls (p > 0.05). The subgroup analysis revealed no significant gene-gene interactions or gene-gene combination effects linked to CAD susceptibility. However, MDR analysis selected the GSTM, GSTT pairwise and three genes combination models associated with the susceptibility to CAD. In addition, its result revealed that smoking in combination with GSTM1 (two-way) and GSTT, GSTP (three-way) genes might increase the risk of CAD. Furthermore, a significant interaction between GSTT1-null polymorphism and dyslipidemia was found in multivariable logistic regression analyses in the gene-environmental interactions on CAD risk. Conclusion: Our results suggest that the GSTM1, GSTT1 and GSTP1 genetic variations are not directly associated with the susceptibility to CAD in Iranian patients. Due to MDR results, there might be a non-linear association between interactions of two or three genes and smoking with CAD. There is also an association between CAD risk factors and GST variations, which requires supplementary confirmation with larger sample sizes.

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Ethnic variations in acute coronary syndromes

Cited by 11 publications

References 12 publications

Platelet reactivity and thrombogenicity in postmenopausal women

Platelet reactivity and thrombogenicity in postmenopausal women

Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010)

<p>Association of <em>GSTP1</em>, <em>GSTT1</em> and <em>GSTM1</em> Gene Variants with Coronary Artery Disease in Iranian Population: A Case–Control Study</p>

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