0
Back To Top Jump Location
Sign In  | Cart
Left Shadow
Right Shadow
Quality of Care and Outcomes Assessment |

INTERACTION OF ETHNICITY WITH HIGH-DENSITY LIPOPROTEIN-CHOLESTEROL PREDICTS ADVERSE CLINICAL OUTCOME OF ASIAN SUBPOPULATIONS WITH ACUTE CORONARY SYNDROME FREE

Angela Koh; Julian Tan; Kenneth Guo; Stanley Chia; Terrance Chua; Tian Hai Koh; Jack Tan
[+] Author Information

ACC Moderated Poster ContributionsMcCormick Place South, Hall AMonday, March 26, 2012, 11:00 a.m.-NoonSession Title: Age, Gender, and Racial Differences in CareAbstract Category: 31. Quality of Care and Outcomes AssessmentPresentation Number: 1259-420

J Am Coll Cardiol. 2012;59(13s1):E1913-E1913. doi:10.1016/S0735-1097(12)61914-7
Published online
text A A A

Previous registry data suggest that ethnic differences amongst Asian subpopulations with acute coronary syndrome exist. We aim to examine if there are additional differences between HDL profiles and clinical outcome among Asians with ACS.

We prospectively studied patients with ACS defined as either unstable angina pectoris or non-ST elevation MI admitted between December 2008 and October 2010. Baseline characteristics of age, gender, diabetes mellitus, hypertension and TIMI score were analyzed and adjusted for outcomes. Lipid profiles were obtained after 12 hours overnight fasting from index hospital admission for ACS. Primary outcomes were major adverse cardiovascular events (MACE) of MI, target vessel revascularization (TVR) and death up to 12 months.

This study consisted of 655 patients (75% males, mean age 60±13) with median follow-up of 9 months and median TIMI score of 4. 63.3% of the cohort had suboptimal HDL level <1.0mmol/L. Compared to those with HDL >1.0mmol/L, patients with HDL <1.0mmol/L were mostly male (p<0.001), Malay (p=0.05) or Indian (p=0.019). Patients with HDL <1.0mmol/L had more MACE at 6- (19.7% vs. 9.9%, OR 2.24 95%CI 1.16-4.33, p=0.016) and 9- months (28% vs. 16%, OR 2.07 95%CI 1.08-3.94, p=0.035). Adjusted analyses demonstrated increased risk of 1-month TVR among the Indians (4.8% vs. 0.6%, OR 8.85 95%CI 1.44-54.50, p=0.045) and 1-month nonfatal MI among the Malays (7.9% vs. 1.7%, OR 5.06 95%CI 1.31-19.52, p=0.038) with HDL<1.0mmol/L. 6-month MACE rates were higher among the Malays and Indians combined (23% vs. 13%, OR 2.04 95%CI 1.13-3.68, p=0.021) with HDL<1.0. Interestingly, Malays and Indians who had HDL >1.5mmol/L on admission appeared to have less MACE at 12 months compared to those who had HDL <1.0mmol/L (26% vs. 41%, OR 2.02 95%CI 1.02-4.01, p=0.06).

Amongst Asian subpopulations, Indians and Malays with low HDL have the highest risk of early adverse cardiovascular outcomes. Further large studies are warranted to explore the reasons behind these observations and support interventions to improve the risk profiles of various ethnic groups.

Figures

Tables

Interactive Graphics

Video

References

Correspondence

Latest JACC CME

Continuing Medical Education through JACC is a convenient way to fulfill your CME requirements while learning important information about the latest advances in cardiovascular medicine.

April 2013- JACC CME Activity
Repeat Revascularization and Outcome

March 2013- JACC CME Activity
Extreme Lipoprotein(a) Levels and Improved Cardiovascular Risk Prediction

Feb 2013- JACC CME Activity
Results from the BARI 2D Trial

Jan 2013- JACC CME Activity
Prognosis Among Healthy Individuals Discharged With a Primary Diagnosis of Syncope

Dec 2012- JACC CME Activity
Incidence of Heart Failure or Cardiomyopathy After Adjuvant Trastuzumab Therapy for Breast Cancer

Nov 2012- JACC CME Activity
A Collaborative Analysis of Individual Patient Data From 10 Randomized Trials

Oct 2012- JACC CME Activity
Radiofrequency Ablation of Premature Ventricular Ectopy Improves the Efficacy of Cardiac Resynchronization Therapy in Nonresponders

Sept 2012- JACC CME Activity
Exercise and Pharmacological Treatment of Depressive Symptoms in Patients With Coronary Heart Disease

Aug 2012- JACC CME Activity
Reduction in Life-Threatening Ventricular Tachyarrhythmias in Statin-Treated Patients With Nonischemic Cardiomyopathy Enrolled in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy)

July 2012- JACC CME Activity
Relationship of Beta-Blocker Dose With Outcomes in Ambulatory Heart Failure Patients With Systolic Dysfunction

For previous CME quizzes, please follow this link to CardioSource Lifelong Learning and MOC.

 

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Related Topics