Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia.

McKeigue, Paul; Ferrie, JE; Pierpoint, T; Marmot, Michael

doi:10.1161/01.cir.87.1.152

Cited by 313 publications

(214 citation statements)

References 40 publications

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“…27 Population studies show that diabetes, insulin resistance, and related metabolic abnormalities are more common among Indian Asians than European whites, and they may account for up to 70% of major Q-wave ECG abnormalities in Asians. 4,5 In the present study, CRP concentrations were also closely associated with levels of HDL cholesterol, triglycerides, glucose, blood pressure, and a composite insulin resistance score in both racial groups. Similar findings have been reported in North American and European populations, which have additionally shown that CRP concentrations and other inflammatory markers, including white cell count and fibrinogen, are strongly associated with plasma insulin and insulinmediated glucose uptake.…”

Section: Discussionsupporting

confidence: 63%

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C-Reactive Protein, Insulin Resistance, Central Obesity, and Coronary Heart Disease Risk in Indian Asians From the United Kingdom Compared With European Whites

et al. 2001

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Background-Indian Asians in the United Kingdom have increased coronary heart disease (CHD) mortality compared with European whites, but the causes are not well understood. Increased circulating concentrations of C-reactive protein (CRP) are an independent risk factor for CHD. Therefore, we investigated this marker of inflammation in healthy UK Indian Asian and European white men. Methods and Results-We measured serum CRP concentrations and conventional CHD risk factors in 1025 healthy male subjects (518 Indian Asians and 507 European whites) aged 35 to 60 years who were recruited at random from general practitioner lists. The geometric mean CRP concentration was 17% higher (95% confidence interval, 3% to 33%) in Indian Asians compared with European whites. CRP values were strongly associated with conventional CHD risk factors, measures of obesity, and metabolic disturbances associated with insulin resistance in both racial groups. The difference in CRP concentrations between Indian Asians and European whites remained after adjustment for conventional CHD risk factors but was eliminated by an adjustment for central obesity and insulin resistance score in Asians. On the basis of these results, we estimate that the processes underlying elevated CRP and/or increased CRP production itself are associated with an Ϸ14% increase in population CHD risk among Indian Asians compared with European whites. Conclusions-CRP

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Section: Discussionsupporting

confidence: 63%

“…1,2 Conventional coronary risk factors, including smoking, hypercholesterolemia, and hypertension, do not explain their increased CHD risk compared with whites. 3,4 Although diabetes and insulin resistance are more prevalent among Indian Asians, 4,5 the precise mechanisms underlying the increased CHD mortality in Indian Asians are not known.…”

mentioning

confidence: 99%

C-Reactive Protein, Insulin Resistance, Central Obesity, and Coronary Heart Disease Risk in Indian Asians From the United Kingdom Compared With European Whites

et al. 2001

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“…A low cut-off age (50 years) to compare prognosis was taken considering the fact that CAD occurs in Indians at a younger age. 7,8 In the GRACE registry, age has been shown to be a statistically significant predictor of events for every 10 years increase in age (OR 1.7/decade). Like in the GRACE registry (OR 1.4 for every 10 mmHg decrease), our study also showed that a lower SBP at admission is significantly associated with more events.…”

Section: Discussionmentioning

confidence: 99%

Validation of the GRACE score for prognosis in Indian patients with acute coronary syndromes

Prabhudesai

Srilakshmi

Santosh

et al. 2012

Indian Heart Journal

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Aim:To validate the global registry of acute coronary events (GRACE) score in acute coronary syndromes (ACS) patients and study its angiographic correlation. Methods and results:Two-hundred and thirty-five ACS patients were studied for the combined endpoint of all-cause in-hospital mortality and non-fatal infarction/reinfarction. We tested the predictive accuracy of the composite GRACE score using the receiver operating characteristics (ROC) curve.Lower systolic blood pressure (SBP) (odds ratio [OR] 7.93, P = 0.005), ST-segment deviation (OR 7.79, P = 0.02) and cardiac biomarker positivity (OR > 6.52, P = 0.01) were significantly associated with events. Serum creatinine > 1.4 mg/dL showed a trend towards statistical significance (OR 4.14, P = 0.05), whereas age > 50 years (OR 3.62, P = not significant [NS]) and Killips class 4 (OR 2.71, P = NS) showed good association. The best value for predicting events was a GRACE score of ≥ 217 and these patients were more likely to have double/triple vessel disease (P = 0.0009). The C statistic for the GRACE score was 0.75. Conclusion:Higher GRACE score predicts in-hospital events and more severe angiographic coronary artery disease (CAD).

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“…17,71,73 A low prevalence of electrocardiographic Q waves has been observed in two Indian studies which have reported on this finding indicating a lower incidence of arteriosclerosis. 17,73 It is possible that south Asian immigrants to developed countries may have a greater incidence of electrocardiographic changes, due to their increased susceptibility to insulin resistance 8,81 which may be decreased by a diet rich in n-3 fatty acids. 82 Higher body mass index in association with hypertension and a higher fat diet has been observed in Japan.…”

Section: Journal Of Human Hypertensionmentioning

confidence: 99%

Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention

et al. 2000

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Reliable statistics related to the prevalence, incidence and mortality of hypertension and stroke are not available from Asia. The data may be in national or institutional reports or journals published in the local language only. The mortality rate for stroke has been on the decline since the mid 1960s in the developed countries of Asia, such as Australia, New Zealand, and Japan, with some improvement in Singapore, Taiwan and Hong Kong, some areas of China and Malaysia about 15 years later. In India, China, Phillippines, Thailand, Sri Lanka, Iran, Pakistan, Nepal, there has been a rapid increase in stroke mortality and prevalence of hypertension. The prevalence of hypertension according to new criteria (Ͼ140/90 mm Hg) varies between 15-35% in urban adult populations of Asia. In rural populations, the prevalence is two to three times lower than in urban subjects.

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Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia.

Cited by 313 publications

References 40 publications

C-Reactive Protein, Insulin Resistance, Central Obesity, and Coronary Heart Disease Risk in Indian Asians From the United Kingdom Compared With European Whites

C-Reactive Protein, Insulin Resistance, Central Obesity, and Coronary Heart Disease Risk in Indian Asians From the United Kingdom Compared With European Whites

Validation of the GRACE score for prognosis in Indian patients with acute coronary syndromes

Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention

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