Objective: To describe and compare demographics and symptom presentation in Asian and Caucasian patients with acute coronary syndromes.
Design: Long-term prospective survey of symptom presentations in two racial groups.
Setting: A London hospital.
Participants: A consecutive series of patients admitted to hospital with acute coronary syndromes between November 2001 and November 2005.
Main outcome measure: Comparison of demographics and location, character, intensity and symptom distribution at presentation between Asian and Caucasian patients.
Results: Asian patients were younger than Caucasian patients (61 v 69 years, p<0.001) and more had diabetes (43% v 17%, p<0.001). Proportionally, more Asian patients had angina (51% v 37%, p<0.001), but more Caucasian patients had myocardial infarction (63% v 49%, p<0.001) and non-ST elevation infarcts (40% v 29%, p<0.001). Men reported smaller areas of discomfort than women. Asian patients more frequently reported discomfort over the rear of their upper bodies compared to Caucasian patients (46% v 25%, p<0.001) and radiation of discomfort to their arms and necks. A higher percentage of Asian than Caucasian patients demonstrated a “classical” location of symptoms (90% v 82%, p<0.001). Patients with diabetes were more likely to feel no discomfort. A higher percentage of Caucasian than Asian patients presented with “silent” events (13% v 6%, p>0.001), with age being a major determinant.
Conclusion: Asian patients were younger, more likely to be diabetic and tended to report a higher intensity of pain and over a greater area of their body, and more frequent discomfort over the rear of their upper thorax than Caucasian patients.
- acute coronary syndrome
- myocardial infarction
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Published Online First 16 August 2006
Competing interests: None.
Ethics approval: Not required.
Authorship statement: I (Dr Simon Dubrey) confirm that all authors have contributed to the writing and interpretation of study data. In addition, all authors have helped in the design of the project and in the final manuscript. I (Dr Simon Dubrey) stand as guarantor of this article and am responsible for the overall content of the paper and have access to all the data therein.