South Asian patients with coronary artery disease were almost three times as likely to be readmitted to hospital for further interventional treatment to arterial plaque than their White European counterparts, according to research in the December issue of IJCP, the International Journal of Clinical Practice . They were also more likely to present as an emergency and require urgent treatment.
Researchers carried out a five-year follow-up study of 1,158 patients who had received percutaneous coronary intervention (PCI) at a UK hospital, comparing 293 South Asians and 865 White Europeans. PCI, which is often known as angioplasty, is carried out to remove the cholesterol-laden plaque that has built up in the arteries leading to the heart, making them narrower and reducing blood flow.
"When we compared the number of further procedures the patients underwent, we found that the South Asian patients were three times as likely to need further procedures than their White European counterparts" says lead author Dr Chetan Varma, from the Department of Cardiology at City Hospital, Birmingham, UK. "Despite this, there were no long-term differences in the all-cause death rates between the two ethnic groups."
The researchers studied consecutive patients who had received PCIs at the hospital between April 2002 and December 2004, following them for between 47 and 65 months. High-risk cases were excluded to remove confounding effects. The majority of the patients were men (72%) and the South Asian patients were of Indian, Pakistani, Bangladeshi and Sri Lankan origin.
Key findings of the study included:
"South Asians develop symptomatic coronary artery disease at an earlier age and also have a higher prevalence than White Europeans" concludes Dr Varma. "PCI can be used for symptomatic relief in stable angina and to improve prognosis in acute coronary syndrome.
"Despite needing more urgent hospital treatment and experiencing worse social deprivation, South Asian patients have a long-term death rate similar to White Europeans. However, they are three times as likely to require repeat treatment following PCI, due to further narrowing of the arteries leading to the heart."
Notes to editors
International Journal of Clinical Practice