TY - JOUR
T1 - Ethnicity modifies associations between cardiovascular risk factors and disease severity in parallel Dutch and Singapore coronary cohorts
AU - Gijsberts, Crystel M.
AU - Seneviratna, Aruni
AU - de Carvalho, Leonardo P.
AU - den Ruijter, Hester M.
AU - Vidanapthirana, Puwalani
AU - Sorokin, Vitaly
AU - Stella, Pieter
AU - Agostoni, Pierfrancesco
AU - Asselbergs, Folkert W.
AU - Richards, A. Mark
AU - Low, Adrian F.
AU - Lee, Chi-Hang
AU - Tan, Huay Cheem
AU - Hoefer, Imo E.
AU - Pasterkamp, Gerard
AU - de Kleijn, Dominique P. V.
AU - Chan, Mark Y.
PY - 2015/7/6
Y1 - 2015/7/6
N2 - BackgroundIn 2020 the largest number of patients with coronary artery disease (CAD) will be found in Asia. Published epidemiological and clinical reports are overwhelmingly derived from western (White) cohorts and data from Asia are scant. We compared CAD severity and all-cause mortality among 4 of the world's most populous ethnicities: Whites, Chinese, Indians and Malays.MethodsThe UNIted CORoNary cohort (UNICORN) simultaneously enrolled parallel populations of consecutive patients undergoing coronary angiography or intervention for suspected CAD in the Netherlands and Singapore. Using multivariable ordinal regression, we investigated the independent association of ethnicity with CAD severity and interactions between risk factors and ethnicity on CAD severity. Also, we compared all-cause mortality among the ethnic groups using multivariable Cox regression analysis.ResultsWe included 1,759 White, 685 Chinese, 201 Indian and 224 Malay patients undergoing coronary angiography. We found distinct inter-ethnic differences in cardiovascular risk factors. Furthermore, the associations of gender and diabetes with severity of CAD were significantly stronger in Chinese than Whites. Chinese (OR 1.3 [1.1-1.7], p = 0.008) and Malay (OR 1.9 [1.4-2.6], pConclusionIn this population of individuals undergoing coronary angiography, ethnicity is independently associated with the severity of CAD and modifies the strength of association between certain risk factors and CAD severity. Furthermore, mortality differs among ethnic groups. Our data provide insight in inter-ethnic differences in CAD risk factors, CAD severity and mortality.
AB - BackgroundIn 2020 the largest number of patients with coronary artery disease (CAD) will be found in Asia. Published epidemiological and clinical reports are overwhelmingly derived from western (White) cohorts and data from Asia are scant. We compared CAD severity and all-cause mortality among 4 of the world's most populous ethnicities: Whites, Chinese, Indians and Malays.MethodsThe UNIted CORoNary cohort (UNICORN) simultaneously enrolled parallel populations of consecutive patients undergoing coronary angiography or intervention for suspected CAD in the Netherlands and Singapore. Using multivariable ordinal regression, we investigated the independent association of ethnicity with CAD severity and interactions between risk factors and ethnicity on CAD severity. Also, we compared all-cause mortality among the ethnic groups using multivariable Cox regression analysis.ResultsWe included 1,759 White, 685 Chinese, 201 Indian and 224 Malay patients undergoing coronary angiography. We found distinct inter-ethnic differences in cardiovascular risk factors. Furthermore, the associations of gender and diabetes with severity of CAD were significantly stronger in Chinese than Whites. Chinese (OR 1.3 [1.1-1.7], p = 0.008) and Malay (OR 1.9 [1.4-2.6], pConclusionIn this population of individuals undergoing coronary angiography, ethnicity is independently associated with the severity of CAD and modifies the strength of association between certain risk factors and CAD severity. Furthermore, mortality differs among ethnic groups. Our data provide insight in inter-ethnic differences in CAD risk factors, CAD severity and mortality.
KW - ACUTE MYOCARDIAL-INFARCTION
KW - SOUTH ASIANS
KW - ARTERY-DISEASE
KW - HEART-DISEASE
KW - CAUCASIAN PATIENTS
KW - UNITED-KINGDOM
KW - MORTALITY
KW - INTERVENTION
KW - CHINESE
KW - ATHEROSCLEROSIS
UR - http://www.scopus.com/inward/record.url?scp=84940094646&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0132278
DO - 10.1371/journal.pone.0132278
M3 - Article
C2 - 26147693
SN - 1932-6203
VL - 10
JO - PLoS ONE [E]
JF - PLoS ONE [E]
IS - 7
M1 - e0132278
ER -