title: Differences in the clinical characteristics of ethnic minority groups with heart failure managed in specialized heart failure clinics.
abstract: OBJECTIVE
  The purpose of our study was to compare the clinical features of Chinese and South Asians, the 2 largest minority populations in Canada, with non-Chinese/non-South Asian (NCH/NSA) patients managed in common social macroenvironments and healthcare systems.
  
  
  BACKGROUND
  Heart failure is an increasingly prevalent condition. Although ethnic minorities comprise a growing proportion of the population in Western countries, the clinical profiles of ethnic minorities with heart failure are largely unknown.
  
  
  METHODS
  We analyzed records of patients with heart failure managed in 2 specialized clinics in Ontario, Canada. Of the 1,671 patients, 181 (11%) were identified as Chinese and 215 (13%) as South Asian.
  
  
  RESULTS
  Our analyses showed that fewer Chinese patients were found to have a history of myocardial infarction (MI) (30% vs. 52%), 3 occluded/stenosed coronary vessels on angiogram (47% vs. 51%), grade 3 or worse left ventricular dysfunction (22% vs. 42%), and a prescription of angiotensin-converting enzyme inhibitors (42% vs. 63%) compared with their NCH/NSA counterparts. In contrast, South Asian patients more frequently had a past history of an MI (70% vs. 52%), 3 occluded/stenosed coronary vessels on angiogram (68% vs. 51%), and treatment with coronary revascularizations (55% vs. 40%) compared with NCH/NSA patients.
  
  
  CONCLUSIONS
  Our study demonstrates important differences in comorbid conditions, clinical characteristics, and treatment patterns among Chinese and South Asian patients compared with NCH/NSA patients with heart failure. Awareness of these differences will help to develop differential strategies necessary to prevent and manage heart failure among ethnic minority groups.
authors.affiliation: Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Diana
authors.initials: D
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Edson
authors.initials: E
authors.lastname: Nemi
authors.affiliation: Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernando
authors.affiliation: Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, McMaster University, Hamilton, Ontario, Canada; Keenan Research Center in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Milan
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Division of Cardiology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Keenan Research Center in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada. Electronic address: moeg@smh.toronto.on.ca.
authors.forename: Gordon W
authors.initials: GW
authors.lastname: Moe
mesh_terms: D000368:Aged; D001211:Asia, Western / Q000208:ethnology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002681:China / Q000208:ethnology; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D054059:Coronary Occlusion / Q000208:ethnology; D023921:Coronary Stenosis / Q000208:ethnology; D004452:Echocardiography / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000208:ethnology* / Q000628:therapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000208:ethnology; D009864:Ontario / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D002316:Cardiotonic Agents
keywords: Chinese; South Asian; ethnic minorities; heart failure