title: Case fatality rates for South Asian and Caucasian patients show no difference 2.5 years after percutaneous coronary intervention.
abstract: OBJECTIVE
  To compare short and medium-term prognosis in South Asian and Caucasian patients undergoing percutaneous coronary intervention (PCI) to determine if there are ethnic differences in case death rates.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A cardiology referral centre in east London.
  
  
  METHODS
  9771 patients who underwent PCI from October 2003 to December 2007 of whom 7966 (81.5%) were Caucasian and 1805 (18.5%) were South Asian.
  
  
  METHODS
  In-hospital major adverse cardiac events (MACE; death, myocardial infarction, stroke and target vessel revascularisation), subsequent revascularisation rates (PCI and coronary artery bypass grafting; CABG) and all-cause mortality during a median follow-up of 2.5 years (range 1.5-3.6 years).
  
  
  RESULTS
  South Asian patients were younger than Caucasian patients (59.69±0.27 vs 64.69±0.13 years, p<0.0001), and more burdened by cardiovascular risk factors, particularly type II diabetes mellitus (45.9%±1.2% vs 15.7%±0.4%, p<0.0001). The in-hospital rates of MACE were similar for South Asians and Caucasians (3.5% vs 2.8%, p=0.40). South Asians had higher rates of clinically driven PCI for restenosis and subsequent CABG, although Kaplan-Meier estimates of all-cause mortality showed no significant differences; this was regardless of whether PCI was performed post-acute coronary syndrome or as an elective procedure. The adjusted hazard of death for South Asians compared with Caucasians was 1.00 (95% CI 0.81 to 1.23).
  
  
  CONCLUSIONS
  In this large PCI cohort, the in-hospital and longer-term mortality of South Asians appeared no worse than that of Caucasians. South Asians had higher rates of restenosis and CABG during follow-up. Data suggest that the excess coronary mortality for South Asians compared with Caucasians is not explained by differences in case-fatality rates.
authors: Department of Cardiology, Barts and the London NHS Trust, London, UK.
authors: D A
authors: DA
authors: Jones
authors: K S
authors: KS
authors: Rathod
authors: N
authors: N
authors: Sekhri
authors: C
authors: C
authors: Junghans
authors: S
authors: S
authors: Gallagher
authors: M T
authors: MT
authors: Rothman
authors: S
authors: S
authors: Mohiddin
authors: A
authors: A
authors: Kapur
authors: C
authors: C
authors: Knight
authors: A
authors: A
authors: Archbold
authors: A K
authors: AK
authors: Jain
authors: P G
authors: PG
authors: Mills
authors: R
authors: R
authors: Uppal
authors: A
authors: A
authors: Mathur
authors: A D
authors: AD
authors: Timmis
authors: A
authors: A
authors: Wragg
mesh_terms: D054058:Acute Coronary Syndrome / Q000208:ethnology / Q000401:mortality* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D044466:Asian People / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D044465:White People / Q000208:ethnology*