Department of Cardiology, City Hospital, Birmingham, UK.
Int J Clin Pract. 2011 Dec;65(12):1259-66. doi: 10.1111/j.1742-1241.2011.02776.x.
The aim of this study was to compare rates of target lesion revascularisation (TLR) and total mortality between South Asians (SAs) and White Europeans (WEs) following percutaneous coronary intervention (PCI).
We followed a cohort of 293 SAs and 865 WEs patients admitted for elective or urgent PCI to de novo lesions. For each patient, baseline cardiovascular risk factors and angiographic data were obtained. Patients had long-term follow-up for all-cause mortality and TLR.
Patients were followed up over a median period of 54 months (inter-quartile range: 47-65). SAs were younger (62 ± 12 years vs. 66 ± 11 years; p < 0.0001), with a higher prevalence of diabetes, greater social deprivation [Carstairs score: 10.2 (IQR 6.5-12.1) vs. 3.3 (IQR 0.9-6.5); p < 0.0001] and presented more acutely (urgent PCI procedure). During the follow-up period, a total of 119 deaths and 111 TLR [94 repeat PCI and 17 coronary artery bypass grafting (CABG)] occurred. There was no significant difference in the rate of long-term all-cause mortality between SA and WE [31 (10.6%) vs. 107 (12.4%); OR: 0.84 (0.55-1.28); p = 0.47]. However, SA ethnicity was an independent predictor of long-term TLR, after adjusting for baseline clinical and procedural characteristics [54 (18.4%) vs. 57 (6.6%); OR: 2.83 (1.87-4.29); p < 0.0001].
South Asian patients were more likely to require re-admission to treat clinical restenosis of the index lesion. There was no significant long-term difference in all-cause mortality between SA and WE patients.
本研究旨在比较经皮冠状动脉介入治疗（PCI）后南亚人（SAs）和白种欧洲人（WEs）的靶病变血运重建（TLR）和总死亡率。
我们对 293 名 SAs 和 865 名 WEs 患者进行了队列研究，这些患者因择期或紧急 PCI 而患有新发病变。为每位患者获取了基线心血管危险因素和血管造影数据。对患者进行了全因死亡率和 TLR 的长期随访。
患者中位随访时间为 54 个月（四分位距：47-65）。SAs 更年轻（62 ± 12 岁 vs. 66 ± 11 岁；p < 0.0001），糖尿病患病率更高，社会剥夺程度更高[卡尔斯塔特评分：10.2（IQR 6.5-12.1） vs. 3.3（IQR 0.9-6.5）；p < 0.0001]，发病更急（紧急 PCI 手术）。在随访期间，共有 119 例死亡和 111 例 TLR[94 例重复 PCI 和 17 例冠状动脉旁路移植术（CABG）]。SA 和 WE 之间的长期全因死亡率没有显著差异[31（10.6%） vs. 107（12.4%）；OR：0.84（0.55-1.28）；p = 0.47]。然而，在校正基线临床和手术特征后，SA 种族是长期 TLR 的独立预测因素[54（18.4%） vs. 57（6.6%）；OR：2.83（1.87-4.29）；p < 0.0001]。
南亚患者更有可能因索引病变的临床再狭窄而需要再次入院治疗。SA 和 WE 患者之间的全因死亡率没有显著差异。
