Hasan Rani K, Ginwala Naeema T, Shah Rhia Y, Kumbhani Dharam J, Wilensky Robert L, Mehta Nehal N
Am J Cardiovasc Dis. 2011;1(1):31-7. Epub 2011 Apr 20.
South Asians are one of the highest risk ethnic groups for development of coronary artery disease (CAD) mortality and morbidity. Previous studies have investigated whether South Asians exhibit differences in angiographic coronary artery disease compared to Caucasians, with inconsistent results. We conducted a retrospective observational study comparing South Asians undergoing cardiac catheterization at a tertiary care institution with Caucasians who underwent catheterization at the same time and location to assess whether South Asians demonstrated smaller coronary artery size and/or increased angiographic coronary artery disease. Demographic and laboratory data were retrospectively abstracted. Quantitative coronary angiographic analysis of all three coronary arteries was performed using the edge-detection method. South Asian patients were younger (57 versus 64 years, p=0.004) and showed higher prevalences of diabetes, dyslipidemia, and acute coronary syndrome compared with Caucasians (40% versus 16%, p=0.004; 65% versus 46%, p=0.04; and 37% versus 10%, p<0.001; respectively). South Asians exhibited smaller normalized proximal LAD luminal diameters (1.56 versus 1.72 mm/m(2), p=0.04) when compared to Caucasians. South Asians also displayed more severe CAD as determined by both increased mean percent stenosis in the proximal LAD and RCA segments (22.7% versus 11.1%, p=0.004; and 24.5% versus 13.9%, p=0.0001, respectively) as well as a higher number of patients with multiple diseased vessel segments. South Asians demonstrated more severe CAD compared to Caucasians undergoing cardiac catheterization as evidenced by smaller proximal LAD luminal diameters, higher mean percent stenosis per vessel, and more patients with multivessel disease. Further study is warranted to better define factors important in the development of CAD and inform risk stratification in this high-risk population.
南亚人是冠心病（CAD）死亡率和发病率最高的风险族群之一。以往的研究调查了南亚人与白种人相比在血管造影显示的冠心病方面是否存在差异，结果并不一致。我们进行了一项回顾性观察研究，将在一家三级医疗机构接受心脏导管插入术的南亚人与同时、同地点接受导管插入术的白种人进行比较，以评估南亚人是否表现出冠状动脉尺寸较小和/或血管造影显示的冠心病增加。人口统计学和实验室数据进行了回顾性提取。使用边缘检测方法对所有三支冠状动脉进行定量冠状动脉血管造影分析。与白种人相比，南亚患者更年轻（57岁对64岁，p = 0.004），糖尿病、血脂异常和急性冠状动脉综合征的患病率更高（分别为40%对16%，p = 0.004；65%对46%，p = 0.04；37%对10%，p < 0.001）。与白种人相比，南亚人表现出较小的标准化近端左前降支（LAD）管腔直径（1.56对1.72 mm/m²，p = 0.04）。根据近端LAD和右冠状动脉（RCA）节段平均狭窄百分比增加也可确定，南亚人还表现出更严重的CAD（分别为22.7%对11.1%，p = 0.004；24.5%对13.9%，p = 0.0001），以及更多有多支病变血管节段的患者。与接受心脏导管插入术 的白种人相比，南亚人表现出更严重的CAD，表现为近端LAD管腔直径较小、每支血管平均狭窄百分比更高以及更多有多支血管疾病的患者。有必要进行进一步研究，以更好地确定在CAD发生中重要的因素，并为这一高危人群的风险分层提供信息。
