Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Can J Cardiol. 2012 Mar-Apr;28(2):178-83. doi: 10.1016/j.cjca.2011.10.014. Epub 2012 Jan 11.
South Asians have a high prevalence of ischemic heart disease and experience high incident acute myocardial infarction (AMI) rates at younger ages than their white counterparts. The aim of this study was to compare outcomes after AMI in a Canadian population of South Asian and white patients, aged 20 to 55 years.
Using hospital discharge abstract administrative data, we included patients with incident AMI, residing in British Columbia and the Calgary Health Region, between April 1, 1995 and March 31, 2002. The cohort was followed for up to 8 years (mean 4.2 years) to determine outcomes of mortality, recurrent AMI, and congestive heart failure (CHF) requiring hospitalization. South Asian ethnicity was determined using validated surname analysis. Baseline demographic characteristics and comorbidities were adjusted using Cox proportional hazard models.
Of 7135 young patients with AMI, 487 were of South Asian ancestry. Compared with white patients, South Asian patients were more likely to have diabetes (25% vs. 12%) and hypertension (24% vs. 20%). After adjustment for sociodemographic and comorbidity variables, there were no significant differences in rates of 30-day mortality (risk adjusted hazard ratio [aHR] 0.90; 95% confidence interval [CI], 0.38-2.10), long-term mortality (aHR 0.81; 95% CI, 0.53-1.26), recurrent AMI (aHR 1.07; 95% CI, 0.89-1.29), or CHF (aHR 0.90; 95% CI, 0.51-1.59) between the 2 groups.
Despite the recognition of increased cardiovascular mortality among young South Asian patients, our Canadian sample demonstrated similar rates of fatal and nonfatal outcomes among young South Asian and white patients with AMI.
南亚人患有缺血性心脏病的比例较高，并且比他们的白人同龄人在更年轻的年龄就经历了较高的急性心肌梗死（AMI）发病率。本研究的目的是比较加拿大南亚裔和白人 20 至 55 岁 AMI 患者的结局。
使用医院出院摘要行政数据，我们纳入了 1995 年 4 月 1 日至 2002 年 3 月 31 日期间居住在不列颠哥伦比亚省和卡尔加里健康区的患有 AMI 的新发病例患者。该队列随访了长达 8 年（平均随访 4.2 年），以确定死亡率、复发性 AMI 和需要住院治疗的充血性心力衰竭（CHF）的结局。南亚种族通过经过验证的姓氏分析来确定。使用 Cox 比例风险模型调整基线人口统计学特征和合并症。
在 7135 名患有 AMI 的年轻患者中，有 487 名患者具有南亚血统。与白人患者相比，南亚裔患者更有可能患有糖尿病（25%对 12%）和高血压（24%对 20%）。在调整社会人口统计学和合并症变量后，30 天死亡率（风险调整后的危害比[aHR]0.90；95%置信区间[CI]，0.38-2.10）、长期死亡率（aHR 0.81；95% CI，0.53-1.26）、复发性 AMI（aHR 1.07；95% CI，0.89-1.29）或 CHF（aHR 0.90；95% CI，0.51-1.59）在两组之间没有显著差异。
尽管年轻南亚裔患者的心血管死亡率得到了认可，但我们的加拿大样本显示，患有 AMI 的年轻南亚裔和白人患者的致命和非致命结局率相似。
