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Angiographic comparison of coronary artery disease between Asians and Caucasians
Insights
Coronary artery disease severity and extent are similar between Asians and Caucasians. However, diabetes is linked to more diffuse coronary lesions in Asian populations.
Area of Science:
- Cardiology
- Public Health
- Ethnic Health Disparities
Background:
- Asians in the UK exhibit higher coronary artery disease (CAD) mortality than Caucasians.
- Understanding ethnic variations in CAD presentation is crucial for targeted interventions.
Purpose of the Study:
- To compare angiographic features of coronary artery disease in Caucasians, British Asians, and Indian Asians.
- To investigate the role of diabetes and other risk factors in CAD presentation across ethnic groups.
Main Methods:
- Coronary angiograms from 87 Caucasians, 83 British Asians, and 30 Indian Asians were analyzed.
- Diabetes status, lipid profiles, and demographic data were assessed.
- Angiographic scores and lesion characteristics were compared between groups.
Main Results:
- Asians were younger but had similar body mass index, blood pressure, and smoking habits compared to Caucasians.
- Diabetes prevalence was higher in Asians.
- While overall disease severity and extent were similar, Asians showed a higher prevalence of non-discrete (long) lesions.
- Diabetes was significantly associated with more extensive disease, particularly long lesions, in both British and Indian Asians.
Conclusions:
- The severity and extent of coronary artery disease do not significantly differ between Asians and Caucasians.
- Diabetes appears to be a key factor contributing to more diffuse coronary artery disease patterns observed in Asian populations.
- Further research into diabetes management within Asian communities is warranted to address CAD disparities.
Abstract:
Asians in the United Kingdom surpass the already high mortality from coronary artery disease seen in Caucasians. In the present study, the angiographic features of consecutive series of 87 Caucasians, 83 British Asian and 30 Asian patients in India with coronary artery disease were assessed. Blood samples at fasting and after ingestion of 75 g of dextrose were taken to assess the extent of diabetes. Fasting blood samples were also taken for measurement of cholesterol, high-density lipoprotein cholesterol and triglyceride. Coronary angiograms were scored by two independent observers who were blinded to the patients' ethnic origin. The Asians were younger than the Caucasians, but did not differ in their body mass index, systolic or diastolic blood pressure or in cigarette consumption. Lipids were similar apart from Indian Asians having lower cholesterol than British Asians, and Caucasians having lower triglyceride than Asians. There were more diabetics in Asians than in Caucasians. Asians in Britain wait longer than Caucasians and Asians in India from onset of angina to undergoing coronary angiography. The presence of triple vessel disease was not significantly different (P = 0.19) in the three groups, that is, 38%, 43% and 27% in Caucasians, British Asians and Indian Asians, respectively. The geometric mean coronary score was 26.3 (C.I. 22.6-30.6), 25.3 (C.I. 21.8-29.4), and 25.2 (C.I. 19.6-32.5) in Caucasians, British Asians and Indian Asians, respectively. This difference was not significant (P = 0.92). Total number of lesions more than three were similar, that is, in 25% Caucasian, 41% British Asian and 40% Indian Asian patients (P < 0.10). British Asians had less proximal disease (P = 0.0002), and Indian Asians less distal disease (P = 0.003) compared to Caucasians. Non-discrete (long) lesions were more prevalent in Asians than Caucasians (P = 0.0005) The total number of lesions more than three in diabetic Asians was significantly more than in the non-diabetic, 71% versus 31% in British Asians (P = 0.002) and 90% versus 15% in Indian Asians (P= 0.0001). The relationship between diabetes and long lesions in both British and Indian Asians was highly significant (P < 0.00001 and P < 0.001, respectively). Thus severity and extent of coronary disease is no different in Asians as compared to Caucasians. Diabetes is perhaps responsible for the more diffuse disease seen in Asians.