Gupta Milan, Doobay Anand V, Singh Narendra, Anand Sonia S, Raja Faisal, Mawji Fazeelat, Kho Julian, Karavetian Alice, Yi Qilong, Yusuf Salim
William Osler Health Centre, Brampton, Ont.
CMAJ. 2002 Mar 19;166(6):717-22.
Coronary artery disease affects a significantly larger proportion of Canadians of South Asian origin than Canadians of other ethnic origins. We compared differences in presentation, risk factors and management of myocardial infarction (MI) between South Asian Canadians and matched control subjects.
We reviewed the charts of 553 South Asian patients and 553 non-South Asian matched control subjects presenting with acute MI (International Classification of Diseases code 410) to 2 hospitals in Canada from January 1994 to April 1999. We identified South Asian subjects by their surnames and first names, and by using self-reported ethnicity and country of birth when available. Patients of Southeast Asian and Middle Eastern origin were excluded. The remaining patients were classified as non-South Asian. Subjects were matched by age within 5 years, sex, discharge date within 6 months and hospital of admission. Presentation characteristics, risk factors and major complications were compared between the 2 groups.
The median time from symptom onset to presentation with acute MI was significantly longer among the South Asian subjects than among the control subjects (3.92 v. 3.08 hours) (p = 0.04). The South Asians were more likely than the control subjects to have diabetes mellitus (43.4% v. 28.2%) (p < 0.001) despite having a significantly lower mean body mass index (25.7 v. 28.0) (p = 0.05) but were less likely to have hyperlipidemia (36.2% v. 42.7%, p = 0.05), to smoke (29.3% v. 67.8%) (p < 0.001) or to have pre-existing vascular disease (49.4% v. 55.0%, p = 0.04). Treatment of acute MI was similar between the South Asian and matched control groups. Also similar were the in-hospital outcomes, including mortality (9.6% and 7.8%, p = 0.27).
There are clear differences in the risk factor profile between Canadians of South Asian origin and those of non-South Asian origin who have acute MI. Despite the higher incidence of cardiovascular disease in the South Asian population, our results indicate that the in-hospital case-fatality rate for MI is the same for South Asian and non-South Asian Canadians.
与其他族裔的加拿大人相比，冠心病在南亚裔加拿大人中的发病率要高得多。我们比较了南亚裔加拿大人与匹配的对照受试者在心肌梗死（MI）的临床表现、危险因素及治疗方面的差异。
我们回顾了1994年1月至1999年4月间在加拿大两家医院就诊的553例南亚患者和553例匹配的非南亚对照受试者的病历，这些患者均表现为急性心肌梗死（国际疾病分类代码410）。我们通过姓氏、名字以及在可行时使用自我报告的种族和出生国家来识别南亚受试者。东南亚和中东裔患者被排除在外。其余患者被归类为非南亚人。受试者按年龄相差5岁以内、性别、出院日期在6个月内以及入院医院进行匹配。比较两组之间的临床表现特征、危险因素和主要并发症。
南亚受试者从症状发作到出现急性心肌梗死的中位时间显著长于对照受试者（3.92对3.08小时）（p = 0.04）。尽管南亚人的平均体重指数显著较低（25.7对28.0）（p = 0.05），但他们患糖尿病的可能性高于对照受试者（43.4%对28.2%）（p < 0.001），而患高脂血症的可能性较小（36.2%对42.7%，p = 0.05），吸烟的可能性较小（29.3%对67.8%）（p < 0.001），或已有血管疾病的可能性较小（49.4%对55.0%，p = 0.04）。南亚组和匹配的对照组之间急性心肌梗死的治疗相似。住院结局也相似，包括死亡率（9.6%和7.8%，p = 0.27）。
南亚裔加拿大人与患有急性心肌梗死的非南亚裔加拿大人在危险因素方面存在明显差异。尽管南亚人群中心血管疾病的发病率较高，但我们的结果表明，南亚裔和非南亚裔加拿大人心肌梗死的住院病死率相同。
