title: 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.
abstract: 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.
authors.forename: Danijela
authors.initials: D
authors.lastname: Gasevic
authors.affiliation: Division of General Internal Medicine, St, Paul's Hospital, Vancouver, BC, Canada. nakhanubc@gmail.com.
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Khan
authors.forename: Hong
authors.initials: H
authors.lastname: Qian
authors.forename: Shahzad
authors.initials: S
authors.lastname: Karim
authors.forename: Gerald
authors.initials: G
authors.lastname: Simkus
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.forename: Martha H
authors.initials: MH
authors.lastname: Mackay
authors.forename: Blair J
authors.initials: BJ
authors.lastname: O'Neill
authors.forename: Amir F
authors.initials: AF
authors.lastname: Ayyobi
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D044466:Asian People / Q000208:ethnology*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000639:trends; D012189:Retrospective Studies; D013223:Statistics as Topic / Q000379:methods*; D016896:Treatment Outcome; D044465:White People / Q000208:ethnology*