Outcomes in a diabetic population of south Asians and whites following hospitalization for acute myocardial infarction: a retrospective cohort study

ORIGINAL ARTICLE, 11 February 2010, VOL I ISSUE I, ISSN 20424906
doi:10.5083/apjcm.20424906.10 , Cite or Link Using DOI
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Aman PK Nijjar1*, Hong Wang2, Kaberi Dasgupta3, Doreen M Rabi4, Hude Quan5, Nadia A Khan1

Background:
The aim of this study was to determine whether South Asian patients with diabetes have a worse prognosis following hospitalization for acute myocardial infarction (AMI) compared with their White counterparts. We measured the risk of developing a composite cardiovascular outcome of recurrent AMI, congestive heart failure (CHF) requiring hospitalization, or death, in these two groups.

Methods:
Using hospital administrative data, we performed a retrospective cohort study of 41,615 patients with an incident AMI in British Columbia and the Calgary Health Region between April 1, 1995, and March 31, 2002. South Asian ethnicity was determined using validated surname analysis. Baseline demographic characteristics and comorbidities were included in Cox proportional hazard models to compare time to reaching the composite outcome and its individual components.

Results:
Among the AMI cohort, 29.7% of South Asian patients and 17.6% of White patients were identified as having diabetes (n = 7416). There was no significant difference in risk of developing the composite cardiovascular outcome (Hazard Ratio = 0.90, 95% CI = 0.80-1.01). However, South Asian patients had significantly lower mortality at long term follow-up (HR = 0.62, 95% CI = 0.51-0.74) compared to their White counterparts.

Conclusions:
Following hospitalization for AMI, South Asian patients with diabetes do not have a significantly different long term risk of a composite cardiovascular outcome compared to White patients with diabetes. While previous research has suggested worse cardiovascular outcomes in the South Asian population, we found lower long-term mortality among South Asians with diabetes following AMI.

  1. Department of Medicine, University of British Columbia, BC, Canada.
  2. Center for Health Evaluation and Outcomes Sciences, University of British Columbia, BC, Canada.
  3. Department of Medicine, McGill University, Quebec, Canada.
  4. Departments of Medicine, Community Health and Cardiac Sciences, University of Calgary, AB, Canada.
  5. Department of Community Health Sciences, University of Calgary, AB, Canada.

Correspondence to:
Aman PK Nijjar, Department of Medicine, University of British Columbia, BC, Canada apnijjar@gmail.com

Keywords:

acute myocardial infarction, diabetic population, south Asians