Differences between South Asians and White Europeans in five year outcome following percutaneous coronary intervention

Toor, Iqbal; Jaumdally, Rumi; Lip, Gregory Y.H.; Pagano, Domenico; Dimitri, Wade R.; Millane, T; Varma, Chetan

doi:10.1111/j.1742-1241.2011.02776.x

Cited by 23 publications

(24 citation statements)

References 33 publications

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“…Many of these differences were small and their clinical relevance is unclear. The younger age of SAs at presentation for initial PCI and the higher rate of diabetes are consistent with previous reports [11, 14, 16–19, 22–24]. Interestingly, the “Other” ethnicity cohort had the lowest rates of diabetes, hypertension and dyslipidemia, yet had the highest rates of vascular disease.…”

Section: Discussionsupporting

confidence: 90%

“…Studies have shown that Canadian, British and Indian SAs experience poorer outcomes than non-SAs following CABG [18–22], especially those with diabetes [20]. British researchers have shown higher rates of re-stenosis, target lesion revascularization and CABG post-PCI among SAs versus non-SAs, but no differences in mortality [23, 24]. Canadian studies examining outcomes following acute MI among SA, Chinese and Caucasian patients have had conflicting findings regarding short-term mortality and recurrent MI [17, 21, 25] although a recent study demonstrated longer survival amongst acute coronary syndrome patients who received revascularization [26].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes following percutaneous coronary revascularization among South Asian and Chinese Canadians

Mackay

Singh

Boone

et al. 2017

BMC Cardiovasc Disord

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BackgroundPrevious data suggest significant ethnic differences in outcomes following percutaneous coronary revascularization (PCI), though previous studies have focused on subgroups of PCI patients or used administrative data only. We sought to compare outcomes in a population-based cohort of men and women of South Asian (SA), Chinese and “Other” ethnicity.MethodsUsing a population-based registry, we identified 41,792 patients who underwent first revascularization via PCI in British Columbia, Canada, between 2001 and 2010. We defined three ethnic groups (SA, 3904 [9.3%]; Chinese, 1345 [3.2%]; and all “Others” 36,543 [87.4%]). Differences in mortality, repeat revascularization (RRV) and target vessel revascularization (TVR), at 30 days and from 31 days to 2 years were examined.ResultsAdjusted mortality from 31 days to 2 years was lower in Chinese patients than in “Others” (hazard ratio [HR] 0.72; 95% confidence interval [CI] 0.53-0.97), but not different between SAs and “Others”. SA patients had higher RRV at 30 days (adjusted odds ratio [OR] 1.30; 95% CI: 1.12-1.51) and from 31 days to 2 years (adjusted hazard ratio [HR] 1.17; 95% CI: 1.06-1.30) compared to “Others”. In contrast, Chinese patients had a lower rate of RRV from 31 days to 2 years (adjusted HR 0.79; 95% CI: 0.64-0.96) versus “Others”. SA patients also had higher rates of TVR at 30 days (adjusted OR 1.35; 95% CI: 1.10-1.66) and from 31 days to 2 years (adjusted HR 1.19; 95% CI: 1.06-1.34) compared to “Others”. Chinese patients had a lower rate of TVR from 31 days to 2 years (adjusted HR 0.76; 95% CI: 0.60-0.96).ConclusionsSA had higher RRV and TVR rates while Chinese Canadians had lower rates of long-term RRV, compared to those of “Other” ethnicity. Further research to elucidate the reasons for these differences could inform targeted strategies to improve outcomes.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Outcomes following percutaneous coronary revascularization among South Asian and Chinese Canadians

Mackay

Singh

Boone

et al. 2017

BMC Cardiovasc Disord

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“…87-4.29), perhaps secondary to their increased rates of DM and IR. 33 In a study examining PCI outcomes in SA versus Europids in the UK, SA were on average 5 years younger, had more extensive disease and nearly triple the rates of DM. 34 However, once corrected for CAD risk factors, SA had a similar prognosis with respect to in-hospital and medium-term mortality.…”

Section: Iii) Prognosismentioning

confidence: 99%

“…32 In a UK based study, SA tended to present more acutely when requiring percutaneous coronary intervention (PCI), but had similar long term mortality rates compared to Europids. 33 However, SA required more frequent readmissions for clinical restenosis (odds ratio (OR) 2.83, 95% CI 1. 87-4.29), perhaps secondary to their increased rates of DM and IR.…”

Section: Iii) Prognosismentioning

confidence: 99%

Cardiovascular Disease in South Asian Migrants

Fernando¹,

Razak²,

Lear³

et al. 2015

Canadian Journal of Cardiology

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“…First, regarding patients’ characteristics, there was no information in the RIM-P database on either symptom or illness severity nor on the socio-economic situation of individual patients. To address this latest limit, we used a deprivation index at the level of patient zip code of residence, following approaches adopted by previous research [83,84,85,86,87,88,89]. Such proxies present the advantage of being mobilizable and operational quickly at a large scale (the national scale in our case) and their use was recently recommended by the French High Council for Public Health whenever individual data are lacking in available information systems [90].…”

Section: Discussionmentioning

confidence: 99%

The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

Gandré

Gervaix

Thillard

et al. 2017

IJERPH

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International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization. The level of development of AFTH was estimated by the share of human resources allocated to those alternatives in the hospital enrolling the staff of each sector. Multi-level modelling was carried out to adjust the analysis on other factors potentially associated with the LOS (patients’, psychiatric sectors’ and environmental characteristics). We observed considerable variations in the LOS between sectors. Although the majority of these variations resulted from patients’ characteristics, a significant negative association was found between the LOS and the development of AFTH, after adjusting for other factors. Our results provide first evidence of the impact of the development of AFTH on mental health care and will provide a lever for policy makers to further develop these alternatives.

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Differences between South Asians and White Europeans in five year outcome following percutaneous coronary intervention

Abstract: South Asian patients were more likely to require re-admission to treat clinical restenosis of the index lesion. There was no significant long-term difference in all-cause mortality between SA and WE patients.

Cited by 23 publications

References 33 publications

Outcomes following percutaneous coronary revascularization among South Asian and Chinese Canadians

Outcomes following percutaneous coronary revascularization among South Asian and Chinese Canadians

Cardiovascular Disease in South Asian Migrants

The Development of Psychiatric Services Providing an Alternative to Full-Time Hospitalization Is Associated with Shorter Length of Stay in French Public Psychiatry

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