THE CLINICAL CHARACTERISTICS AND HOSPITAL COURSE OF THE SOUTH ASIAN POPULATION PRESENTING WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN CANADA

Canada is a multicultural country and a significant population residing in the lower mainland of British Columbia consists of South Asians. We compared the clinical characteristics of the South Asians who presented with ST-segment elevation myocardial infarction (STEMI) with STEMI patients from other ethnicities. A tertiary cardiac center provides 24/7 acute infarct revascularization for the Fraser Health Region that encompasses 1.6 million population, including nearly 20% of which are South Asians. Patients' demographics, clinical presentation, procedural data, and in-hospital course, were prospectively recorded in a registry. Between April 2009 and March 2011, 1,332 patients were referred for emergency cardiac catheterization for STEMI, and 139 (10.4%) were South Asians. Data of the demographic and the clinical course of all patients presenting with STEMI were prospectively collected. When compared with patients from other ethnicities, South Asians with STEMI tended to present at an earlier age (age <70 years: 78% vs 65%, P = 0.002), and they are more likely to have diabetes (37% vs 21%, P = 0.001), hyperlipidemia (46% vs 36%, P = 0.029), and less likely to be a smoker (11.2% vs 34.4%, P = 0.001). They also tended to have a better left ventricular ejection fraction (47% vs 43%, P = 0.001) and cardiac arrest before the emergency procedure (10.9% vs 6.7%, P = 0.086). The location of infarct, door-to-balloon times, first medical contact-to-balloon times, rates of congestive heart failure and cardiogenic shock, were similar between the 2 groups. The rates of all-cause mortality (9.5% vs 8.6%, P = 0.76) and cardiac death (7.2% vs 6.4, P = 0.71) of South Asians were similar to the rest of the population. South Asians with STEMI were younger and more likely had diabetes and hyperlipidemia than patients with other ethnic background. Primary prevention and education related to metabolic syndrome play an important role in reducing STEMI events, particularly in South Asian population.