title: Clinical characteristics, process of care and outcomes among Mexican, Hispanic and non-Hispanic white patients presenting with non-ST elevation acute coronary syndromes: data from RENASICA and CRUSADE registries.
abstract: BACKGROUND
  Data regarding management characteristics of non-ST elevation acute coronary syndromes (NSTE ACS) in Mexican, Hispanic and Non- Hispanic white patients are scarce.
  
  
  METHODS
  We sought to describe the clinical characteristics, process of care, and outcomes of Mexicans, Hispanics and non-Hispanic whites presenting with NSTE ACS at Mexican and US hospitals. We compared baseline characteristics, resource use, clinical practice guidelines (CPGs) compliance and in-hospital mortality among 3 453 Mexicans, 3 936 Hispanics and 90, 280 non-Hispanic whites with NSTE ACS from the RENASICA and CRUSADE registries.
  
  
  RESULTS
  Mexicans were younger with a different cardiovascular risk profile, fewer incidences of hypertension (p<0.001), hyperlipidemia (p<0.001), renal failure (p<0.001) and prior revascularization (p<0.001) but were more likely to be smoking compared with Hispanics and non-Hispanic white populations. Mexicans and Hispanics had a higher incidence of diabetes (p<0.001). At clinical presentation Mexican patients were more likely to have ST depression (p<0.001) but less likely to have left ventricular dysfunction (p<0.001) and troponin stratification (p<0.001). Regarding CPGs compliance, aspirin was used in 90% of patients in all groups, but clopidogrel or unfractionated or low-molecular weight heparin in 50% of patients or less. Mexican patients were less likely to receive glycoprotein IIb/IIIa inhibitors and revascularization. In spite of clinical differences and therapeutic trends, cardiovascular mortality was similar among all groups (Mexicans 4%, Hispanics 4% and non-Hispanic white 5%). In all groups of patients, a poor CPGs compliance was observed.
  
  
  CONCLUSIONS
  In a post-hoc analysis, Mexican patients with NSTE ACS had a different cardiovascular risk factor profile and clinical presentation, and less intensive in - hospital treatment than Hispanic and non-Hispanic white patients. However, these differences do not appear to affect in - hospital mortality.
authors.affiliation: Departamento de Investigación Clínica del Instituto de Cardiología y Medicina Vascular del Tecnológico de Monterrey. Departamento de la Unidad de Investigación Clínica en Medicina SC. Monterrey, N.L., México.
authors.forename: Carlos Jerjes
authors.initials: CJ
authors.lastname: Sánchez-Diaz
authors.forename: Edgar
authors.initials: E
authors.lastname: García-Badillo
authors.forename: Carlos Jerjes
authors.initials: CJ
authors.lastname: Sánchez-Ramírez
authors.forename: Úrsulo
authors.initials: Ú
authors.lastname: Juárez
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez-Sánchez
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D006630:Hispanic or Latino; D006801:Humans; D008800:Mexico; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D044465:White People