title: Coronary artery disease in South Asian immigrants living in New York City: angiographic findings and risk factor burdens.
abstract: BACKGROUND
  The prevalence of coronary artery disease (CAD) among South Asians (SAs) significantly exceeds that of Caucasians. South Asians also suffer from more premature, clinically aggressive and angiographically extensive (3-vessel) disease. The role of conventional CAD risk factors (CCRFs) remains controversial.
  
  
  OBJECTIVE
  We sought to determine if the CCRF burdens of SA immigrants differed from Caucasians. We also sought to determine whether angiographic CAD was more extensive among SAs and whether SA ethnicity was an independent predictor of 3-vessel disease.
  
  
  METHODS
  We reviewed the CCRFs and angiograms of 520 SAs and 219 Caucasians consecutively referred with stable angina pectoris or acute coronary syndrome.
  
  
  RESULTS
  Three-vessel CAD was significantly more common among SAs than Caucasians (32.5% vs 22.4%; P = .006). Diabetes mellitus (DM), age and male sex independently predicted 3-vessel disease. South Asian ethnicity showed a trend toward predicting 3-vessel disease (P = .06). The frequency of DM (55% vs 31.1%; P < .001), hypertension (77.5% vs 68.5%; P = .01), obesity (63.1% vs 44.3%; P < .001) and dyslipidemia (75.6% vs 61.6%; P < .001) were significantly greater among SAs; however, smoking was significantly more common among Caucasians (44.3% vs 21.3%; P < .001). Compared to Caucasians, SAs were significantly younger at the time of presentation for coronary angiography (58.5 vs 61.1 yrs; P = .001).
  
  
  CONCLUSIONS
  SAs referred for coronary angiography with stable angina and acute coronary syndromes are younger, have significantly higher rates of 3-vessel disease, as well as higher rates of DM, hypertension, obesity and dyslipidemia than Caucasians. Aggressive screening, prevention and treatment may be warranted in this population.
authors.affiliation: Mount Sinai School of Medicine, New York, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Silbiger
authors.forename: Russell
authors.initials: R
authors.lastname: Stein
authors.forename: Monisankar
authors.initials: M
authors.lastname: Roy
authors.forename: Murali K
authors.initials: MK
authors.lastname: Nair
authors.forename: Pilar
authors.initials: P
authors.lastname: Cohen
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shaffer
authors.forename: Arthur
authors.initials: A
authors.lastname: Pinkhasov
authors.forename: Mazullah
authors.initials: M
authors.lastname: Kamran
mesh_terms: D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D001459:Bangladesh / Q000208:ethnology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000208:ethnology*; D003920:Diabetes Mellitus / Q000208:ethnology; D050171:Dyslipidemias / Q000208:ethnology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D007194:India / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009765:Obesity / Q000208:ethnology; D010154:Pakistan / Q000208:ethnology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data