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Coronary artery disease
Original article
Survival in South Asian and White European patients after acute myocardial infarction
  1. Nitin N Gholap1,2,
  2. Kamlesh Khunti1,3,4,
  3. Melanie J Davies3,5,
  4. Danielle H Bodicoat1,3,
  5. Iain B Squire6,7
  1. 1Diabetes Research Centre, University of Leicester, Leicester, UK
  2. 2Department of Diabetes and Endocrinology, and Department of Acute Medicine, University Hospitals Coventry and Warwickshire, Coventry, UK
  3. 3Leicester Clinical Trials Unit, University of Leicester, Leicester Diabetes Centre, Leicester, UK
  4. 4NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC), Leicester, UK
  5. 5Lifestyle & Physical Activity Biomedical Research Unit, Leicester-Loughborough NIHR Diet, Leicester, UK
  6. 6Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  7. 7Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK
  1. Correspondence to Dr Nitin Narayan Gholap, Department of Diabetes and Endocrinology, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK; ng94{at}le.ac.uk

Abstract

Objective To examine the association between ethnicity and survival following acute myocardial infarction (AMI) in White European (WE) and South Asian (SA) patients from a multiethnic UK population.

Methods Retrospective, cohort study of 4111 (N=730, 17.8% of SA ethnicity) hospitalised patients, with AMI from a tertiary coronary care centre in the UK, admitted between October 2002 and September 2008. The primary end point was all-cause mortality. The association of ethnicity with survival post AMI was assessed using the Cox regression analysis.

Results Compared with WE patients, SA patients were on average younger (62.0 years vs 67.3 years) and had higher prevalence of cardiovascular risk factors including diabetes (39.7% vs 16.1%). During follow-up (median 912, range 1–2556, days), crude mortality rate was 22.6% in SA patients and 26.0% in WE patients (p=0.061). SA ethnicity did not show univariate (HR 0.85 (0.72 to 1.01)) or multivariate (HR, 1.12 (0.94 to 1.34)) association with mortality. Findings were similar for mortality during 0–30 days (1.30 (0.99 to 1.70)), >30 days−1 year (0.97 (0.67 to 1.40)), >1 year–3 years (1.21 (0.83 to 1.76)), >3 years (0.82 (0.47 to 1.41)), and for long-term mortality in survivors from 30 days (1.02 (0.81 to 1.29)).

Conclusions When adjusted for differing prevalence of cardiovascular risk factors in the two ethnic groups, survival following AMI was similar for SA and WE patients in the UK.

https://doi.org/10.1136/heartjnl-2014-305730

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