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. 2006 Aug;92(8):1030-4.
doi: 10.1136/hrt.2005.078634. Epub 2005 Dec 30.

Declining case fatality rates for acute myocardial infarction in South Asian and white patients in the past 15 years

R Liew  1 , S Sulfi, K Ranjadayalan, J Cooper, A D Timmis
Affiliations

Declining case fatality rates for acute myocardial infarction in South Asian and white patients in the past 15 years

R Liew et al. Heart. 2006 Aug.

Abstract

Objectives: To determine whether case fatality rates in South Asian (Bangladeshi, Indian and Pakistani) patients with acute myocardial infarction have shown similar declines to those reported for white patients during the past 15 years.

Design: Cross-sectional, observational study.

Setting: Coronary care unit in east London.

Patients: 2640 patients-29% South Asian-admitted with acute myocardial infarction between January 1988 and December 2002.

Main outcome measures: Differences over time in rates of in-hospital death, ventricular fibrillation and left ventricular failure.

Results: The proportion of South Asians increased from 22% in 1988-92 to 37% in 1998-2002. Indices of infarct severity were similar in South Asian and white patients, with declining frequencies of ST elevation infarction (88.2% to 77.5%, p < 0.0001), Q wave development (78.1% to 56.9%, p < 0.0001) and mean (interquartile range) peak serum creatine kinase concentrations (1250 (567-2078) to 1007 (538-1758) IU/l, p < 0.0001) between 1988-92 and 1998-2002. Rates of in-hospital death (13.0% to 9.4%, p < 0.01), ventricular fibrillation (9.2% to 6.0%, p < 0.001) and left ventricular failure (33.2% to 26.5%, p < 0.0001) all declined; these changes did not interact significantly with ethnicity. Odds ratios for the effect of time on risk of death increased from 0.81 (95% CI 0.70 to 0.93) to 1.02 (95% CI 0.87 to 1.21) after adjustment for ethnicity and indices of infarct severity (ST elevation, peak creatine kinase, Q wave development and treatment with a thrombolytic).

Conclusions: In the past 15 years, death from acute myocardial infarction among South Asians has declined at a rate similar to that seen in white patients. This is largely caused by reductions in indices of infarct severity.

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Conflict of interest statement

Competing interests: none declared

References

    1. Tunstall‐Pedoe H, Kuulasmaa K, Mahonen M.et al Contribution of trends in survival and coronary‐event rates to changes in coronary heart disease mortality: 10‐year results from 37 WHO MONICA project populations. Monitoring trends and determinants in cardiovascular disease. Lancet 19993531547–1557. - PubMed
    1. Greenbaum R A, Morris R, Sritara P.et al Reduced in‐hospital mortality from acute myocardial infarction with general adoption of thrombolytic treatment in the North West Thames health region 1979–1991. Br Heart J 199574493–496. - PMC - PubMed
    1. Dellborg M, Eriksson P, Riha M.et al Declining hospital mortality in acute myocardial infarction. Eur Heart J 1994155–9. - PubMed
    1. Ranjadayalan K, Umachandran V, Timmis A D. Clinical impact of introducing thrombolytic and aspirin therapy into the management policy of a coronary care unit. Am J Med 199292233–238. - PubMed
    1. Unal B, Critchley J A, Capewell S. Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation 20041091101–1107. - PubMed