Outcomes in Young South Asian Canadians After Acute Myocardial Infarction

Albarak, Jasem; Nijjar, Aman P.; Aymong, Eve; Wang, Hong; Quan, Hude; Khan, Nadia

doi:10.1016/j.cjca.2011.10.014

Cited by 23 publications

(19 citation statements)

References 28 publications

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“…Our study is also one of the few studies [11,12,17] to examine whether there were ethnic differences in clinical features and outcomes in a multi-ethnic population for premature AMI. A local study (inclusive of residents aged 20 to 64 years old) by Mak et al [18] had shown that the MI event rates rate for Indians and Malays were much higher than Chinese with overall rate ratios of 3.1 and 2.1 respectively.…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Wong

Loh²,

Loh³

et al. 2012

WJC

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AIM:To investigate the clinical features and in-hospital outcomes of young adults with acute myocardial infarction (AMI) in Singapore. METHODS:Between January 2005 to September 2010, 333 consecutive patients aged ≤ 45 years old were diagnosed to have AMI at our institution. As Singapore is a multi-ethnic society, we also analysed whether ethnic differences exist between the three dominant ethnic groups, Malay, Chinese and Indian with regards to the clinical features. Clinical data was collected retrospectively on demographic characteristics, presenting signs and symptoms, blood investigation, angiographic findings and in-hospital clinical outcomes. RESULTS:The mean age at presentation was 40.2 ± 4.0 years with male predominance (94%). The majority of patients were Chinese (51%) followed by Indians (31%) and Malays (18%). The most common risk factor was smoking (74%) followed by hypertension (28.5%) and hyperlipidemia (20.0%). 37% of patients were obese. The majority of patients had single vessel disease (46%) on coronary angiography. The mean total cholesterol, low-density lipoprotein and highdensity lipoprotein levels were 5.6 ± 1.2 mmol/L, 3.8 ± 1.1 mmol/L and 0.93 ± 0.25 mmol/L respectively. The mean left ventricular function was 44% ± 10% with the incidence of heart failure 3% and cardiogenic shock 4.5%. Overall in-hospital mortality was low with 4 deaths (1.2%). For ethnic subgroup analysis, Indians have a 3-fold risk of developing premature AMI when compared to other ethnic groups. CONCLUSION:Young AMI patients in Singapore are characterized by male predominance, high incidence of smoking and obesity. Overall in-hospital clinical outcomes are favourable. Among the 3 ethnic groups, Indians have the highest risk of developing premature AMI.

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Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Wong

Loh²,

Loh³

et al. 2012

WJC

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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: 99%

“…The median time from symptom onset to presentation to a hospital in a southern Ontario sample 9 was about 1 hour longer for South Asian people than white people (3.92 h v. 3.08 h, p = 0.04). 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.…”

Section: Diagnosis Management and Outcomesmentioning

confidence: 99%

“…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). …”

mentioning

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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Coronary Heart Disease Among Non-Western Immigrants in Europe

Modesti

Fedeli

2018

Updates in Hypertension and Cardiovascular Protection

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Outcomes in Young South Asian Canadians After Acute Myocardial Infarction

Cited by 23 publications

References 28 publications

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

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

Coronary Heart Disease Among Non-Western Immigrants in Europe

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