Outcomes following percutaneous coronary intervention and coronary artery bypass grafting surgery in Chinese, South Asian and white patients with acute myocardial infarction: administrative data analysis

BMC Cardiovascular Disorders

Amir F Ayyobi¹  Blair J O’Neill³  Martha H Mackay⁵  Hude Quan⁴  Gerald Simkus¹  Shahzad Karim¹  Hong Qian²  Nadia A Khan²  Danijela Gasevic¹ 

[1] Cardiac Services, Royal Columbian Hospital, New Westminster, BC, Canada;Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, 1081 Burrard Street, room 620-B, Vancouver, BC V6Z 1Y6, Canada;Department of Medicine, Division of Cardiology, University of Alberta, Edmonton, Canada;Department of Medicine, University of Calgary, Calgary, AB, Canada;Heart Centre, St. Paul’s Hospital, Vancouver, BC, Canada

关键词: Outcomes;    AMI;    Ethnicity;    CABG;    PCI;   

Others  :  855940
DOI  :  10.1186/1471-2261-13-121

 received in 2013-03-13, accepted in 2013-12-11,  发布年份 2013

【 摘 要 】

Background

Little is known on whether there are ethnic differences in outcomes following percutaneous coronary intervention (PCI) and coronary artery bypass grafting surgery (CABG) after acute myocardial infarction (AMI). We compared 30-day and long-term mortality, recurrent AMI, and congestive heart failure in South Asian, Chinese and White patients with AMI who underwent PCI and CABG.

Methods

Hospital administrative data in British Columbia (BC), Canada were linked to the BC Cardiac Registry to identify all patients with AMI who underwent PCI (n = 4729) or CABG (n = 1687) (1999–2003). Ethnicity was determined from validated surname algorithms. Logistic regression for 30-day mortality and Cox proportional-hazards models were adjusted for age, sex, socio-economic status, severity of coronary disease, comorbid conditions, time from AMI to a revascularization procedure and distance to the nearest hospital.

Results

Following PCI, Chinese had higher short-term mortality (Odds Ratio (OR): 2.36, 95% CI: 1.12-5.00; p = 0.02), and South Asians had a higher risk for recurrent AMI (OR: 1.34, 95% CI: 1.08-1.67, p = 0.007) and heart failure (OR 1.81, 95% CI: 1.00-3.29, p = 0.05) compared to White patients. Risk of heart failure was higher in South Asian patients who underwent CABG compared to White patients (OR (95% CI) = 2.06 (0.92-4.61), p = 0.08). There were no significant differences in mortality following CABG between groups.

Conclusions

Chinese and South Asian patients with AMI and PCI or CABG had worse outcomes compared to their White counterparts. Further studies are needed to confirm these findings and investigate potential underlying causes.

【 授权许可】

   
2013 Gasevic et al.; licensee BioMed Central Ltd.

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