Abstract 1632: Are There Ethnic Differences in Clinical Outcome Following Percutaneous Coronary Intervention Among Asian Subpopulations?
Background and Aim Previous observational data have reported ethnic differences in myocardial infarction event and mortality rates. However, it is not known whether clinical profile and outcome differ between subpopulations of Asian patients who undergo percutaneous coronary intervention (PCI) for coronary artery disease. Therefore, we aim to explore the differences in outcome in a prospective registry of Chinese, Malay and Indian Asian patients who undergo PCI.
Methods We prospectively collected data on consecutive patients undergoing PCI between 2002 and 2007. Baseline clinical characteristics and patient follow up data were obtained from medical records or telephone follow-up. Primary outcomes were major adverse cardiovascular events (MACE) of myocardial infarction (MI), repeat revascularization and all-cause death at one month and six months.
Results From our registry data, 7544 patients (79% males) with mean age of 59 years (±SD11) underwent PCI. There were more ethnic Chinese (68%), compared to Malays and Indians. There were no differences in baseline clinical characteristics of age and gender between the groups (p=ns). Compared to Chinese and Malays, Indian patients had significantly higher rates of one month MACE (Chinese 4.1% vs. Malays 5.2% vs. Indians 6.6%) (p=0.004) and six month MACE (Chinese 8.2% vs. Malays 10.7% vs. Indians 12.0%) (p<0.001). After adjusting for age, gender, risk factors and clinical presentation, Indians had higher one month (OR 1.64 95%CI 1.23–2.19 p=0.001) and six month MACE (OR 1.55 95%CI 1.24 –1.93 p<0.001) with higher likelihood of MI (OR 4.49 95%CI 1.91–10.56 p=0.001) and repeat revascularization at one month (OR 1.64 95%CI 1.22–2.21 p=0.0012) as well as repeat revascularization (OR 1.59 95%CI 1.27–1.98 p<0.001) and death (OR 1.65 95%CI 1.23–2.20 p=0.001) at six months. Malays had higher likelihood of MACE at six months (OR 1.36 95%CI 1.09 –1.69 p=0.006) largely due to repeat revascularization (OR 1.35 95%CI 1.08 –1.69 p=0.009) at six months.
Conclusion In this large Asian subpopulation, we have demonstrated ethnic variation following PCI. In particular, Indian patients have higher six month event rates. Future studies are warranted to explain the underlying mechanisms behind these variations.