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Coronary artery disease in Asians in Birmingham
Insights
Asian patients exhibit more severe coronary artery disease (CAD) than white patients, despite similar disease patterns. This increased severity led to more Asians being denied coronary artery bypass surgery.
Area of Science:
- Cardiology
- Vascular Biology
- Public Health
Background:
- Coronary artery disease (CAD) presents varying severity and risk factors across ethnic groups.
- Clinical observations suggest potential differences in CAD presentation between Asian and white populations.
Purpose of the Study:
- To compare the severity and pattern of coronary artery disease (CAD) between Asian and white patients.
- To investigate associated risk factors and clinical outcomes in these populations.
Main Methods:
- Blind, repeated comparison of coronary angiograms from 34 Asian and 68 white patients.
- Matching patients for age, sex, blood pressure, and symptom duration.
- Examination of risk factors (smoking, cholesterol, body mass) and surgical outcomes.
Main Results:
- Coronary artery disease (CAD) was quantitatively more severe in Asian patients.
- The distribution pattern of CAD was similar between Asian and white patients.
- Significant differences in risk factors: fewer Asian smokers, higher white cholesterol, and greater white body surface area.
Conclusions:
- Asian patients in Birmingham demonstrated more severe coronary artery disease (CAD) than matched white patients.
- Higher CAD severity in Asians resulted in a greater proportion being unsuitable for coronary artery bypass surgery.
- While CAD severity differs, the distribution pattern appears consistent across these ethnic groups.
Abstract:
The severity and pattern of coronary artery disease in patients referred for investigation of the disease was compared between Asian and white patients living in Birmingham, matched for age, sex, blood pressure, and duration of symptoms, to investigate the clinical impression that Asians have worse, in particular worse distal, coronary artery disease than whites. Risk factors and outcome were also examined. The coronary angiograms of 34 Asians were compared blindly and repeatedly with those of 68 whites by two independent observers. Coronary artery disease was found to be quantitatively more severe in Asians, but the distribution of the disease was the same. Some risk factors were significantly different: fewer Asians were smokers; fasting cholesterol concentrations were higher in whites; and whites were heavier, with a larger body surface area. Follow up data showed that more Asians were refused coronary artery bypass surgery because of the severity of their disease.