Navigation Links
South Asian patients require 3 times as much repeat angioplasty as white Europeans
Date:11/21/2011

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 Asian patients tended to be younger than White European patients (62 versus 66 years), more then twice as likely to have diabetes (40% v 16%), but less likely to be smokers (16% v 39%).

  • The extent of the coronary artery disease and the location of the index coronary vessel lesion when the first PCI procedure was carried out was similar in both ethnic groups.

  • A total of 111 patients required repeat revascularisation. Of these, 94 had a repeat PCI and 17 underwent coronary artery bypass grafting. South Asian patients were almost three times as likely to be readmitted for PCI (15.7% v 5.5%) or coronary artery bypass grafting (2.7% v 1.0%).

  • Following the initial procedure, South Asian patients also required more PCI for treatment of non-index lesions (24.2% v 8.9%). After controlling for baseline clinical and procedural characteristics, South Asian ethnicity was a significant independent predictor of target lesion revascularisation, with levels approximately three times higher (18.4% v 6.6%).

  • The patients were followed up for a median of 54 months. During this period 12% of the patients died, but there was no statistically significant difference in the two groups when it came to all-cause death.

  • Social deprivation was three times higher among South Asian patients (10.2 v 3.3 points) as measured by the Carstairs index, which is based on key census indicators. The hospital's catchment area includes areas with unemployment rates of twice the national average and the second lowest average earnings in England and Wales.

  • Each one point increase in the Carstairs social deprivation score was matched by a 5% increase in the risk of long-term, all-cause death.

  • Further analysis (Cox regression) showed that age, history of heart attacks, social deprivation score and creatinine levels before treatment were independent predictors of long-term, all-cause death in the whole study group.

"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."


'/>"/>

Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Southeast U.S. Still Using High Levels of Antibiotics, Study Shows
2. Blood test could identify smokers at higher risk for heart disease, UT Southwestern researchers find
3. UT Southwestern study shows estrogen works in the brain to keep weight in check
4. UT Southwestern and University of Cape Town announce 5-year affiliation agreement
5. UT Southwestern, Parkland partner for $6.3 million NCI grant to improve colorectal cancer screenings
6. Earlier male circumcision may help to slow rates of HIV, HPV transmission in South Africa
7. UT Southwestern scientist shares 2011 Nobel Prize in Physiology or Medicine
8. Older people are happier in Brazil and South Africa
9. South Africas toxic legacy: Acid mine drainage threatens water supplies
10. US Department of Defense awards University of South Florida $1.59 million for musculoskeletal research
11. Chronic vulvar pain a reality for more than 100,000 women in southeast Michigan
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture ... said Christina Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package ... Final Cut Pro X . Simply select a ProHand generator and drag it ...
(Date:6/25/2016)... Oklahoma City, Oklahoma (PRWEB) , ... June 25, ... ... to helping both athletes and non-athletes recover from injury. Recently, he has implemented ... for the Oklahoma City area —Johnson is one of the first doctors to ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June 14 ... The article goes on to state that individuals are now more comfortable seeking to ... operations such as calf and cheek reduction. The Los Angeles area medical group, Beverly ...
(Date:6/24/2016)... ... ... Marcy was in a crisis. Her son James, eight, was out of control. Prone to ... , “When something upset him, he couldn’t control his emotions,” remembers Marcy. “If there ... my other children and say he was going to kill them. If we were ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda ... orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, including ... accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 Research and ... Market for Companion Diagnostic Tests" report to their offering. ... for Companion Diagnostics The World Market for ... personalized medicine diagnostics. Market analysis in the report includes the ... Market (In Vitro Diagnostic Kits) by Region (N. America, EU, ...
(Date:6/23/2016)... , June 23, 2016  MedSource announced today ... its e-clinical software solution of choice.  This latest ... possible value to their clients by offering a ... preferred relationship establishes nowEDC as the EDC platform ... MedSource,s full-service clients.  "nowEDC has long been a ...
(Date:6/23/2016)... Roche (SIX: RO, ROG; OTCQX: RHHBY) announced ... BRAHMS PCT (procalcitonin) assay as a dedicated testing solution ... this clearance, Roche is the first IVD company in ... sepsis risk assessment and management. PCT is ... levels in blood can aid clinicians in assessing the ...
Breaking Medicine Technology: