Coronary artery surgery in Asian patients

We studied retrospectively, 412 consecutive Asian patients undergoing coronary artery bypass grafting between January 1st, 1982 and June 30th, 1987. The mean age was 55 +/- 9 years at operation with a 70.5% male predominance. Patients of Chinese origin accounted for 60.9%, Indonesian for 26.4%, Indian 9.9% and Malaysian 2.6%. Chronic stable angina was the most consistent presenting symptom in 71% and 49% had at least one myocardial infarction in the past. Fifty percent were hypertensive and 26% diabetic. Left main stem coronary artery obstruction was evident in 21.6% and the coronary arteries diffusely diseased in 53%. An average of 3.8 +/- 0.4 grafts were performed per patient using reversed saphenous vein, and endarterectomies were necessitated in 27.1%. The small calibre of coronary arteries in Asian patients was reflected by 54% of grafted vessels having a luminal diameter of 1.5 mm. The early mortality rate and the peri-operative myocardial infarction rate was 1.2% in each instance. A mean follow-up of 30 months revealed a late mortality of 1.9% and 76% of patients were in NYHA Functional Class I. This study suggests that despite a high incidence of hypertension, diabetes and diffuse coronary artery disease Asian patients tolerate coronary artery bypass graft surgery well and obtain significant benefit from it.