Acute coronary syndromes and their presentation in Asian and Caucasian patients in Britain.
OBJECTIVE
To describe and compare demographics and symptom presentation in Asian and Caucasian patients with acute coronary syndromes.


METHODS
Long-term prospective survey of symptom presentations in two racial groups.


METHODS
A London hospital.


METHODS
A consecutive series of patients admitted to hospital with acute coronary syndromes between November 2001 and November 2005.


METHODS
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.


CONCLUSIONS
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.
Teoh
Molly
M
Department of Cardiology, Hillingdon Hospital, Pield Heath Road, Uxbridge, Middlesex UB8 3NN, UK.
Lalondrelle
Susan
S
Roughton
Michael
M
Grocott-Mason
Richard
R
Dubrey
Simon W
SW
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000208:ethnology; D044466:Asian People; D002637:Chest Pain; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000208:ethnology; D017288:Pain Threshold; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013577:Syndrome; D006113:United Kingdom; D044465:White People