Survival in South Asian and White European patients after acute myocardial infarction

OBJECTIVE: To examine the association between ethnicity and survival following acute myocardial infarction (AMI) in White European (WE) and South Asian (SA) patients from a multiethnic UK population. METHODS: Retrospective, cohort study of 4111 (N=730, 17.8% of SA ethnicity) hospitalised patients, with AMI from a tertiary coronary care centre in the UK, admitted between October 2002 and September 2008. The primary end point was all-cause mortality. The association of ethnicity with survival post AMI was assessed using the Cox regression analysis. RESULTS: Compared with WE patients, SA patients were on average younger (62.0 years vs 67.3 years) and had higher prevalence of cardiovascular risk factors including diabetes (39.7% vs 16.1%). During follow-up (median 912, range 1-2556, days), crude mortality rate was 22.6% in SA patients and 26.0% in WE patients (p = 0.061). SA ethnicity did not show univariate (HR 0.85 (0.72 to 1.01)) or multivariate (HR, 1.12 (0.94 to 1.34)) association with mortality. Findings were similar for mortality during 0-30 days (1.30 (0.99 to 1.70)), > 30 days-1 year (0.97 (0.67 to 1.40)), > 1 year-3 years (1.21 (0.83 to 1.76)), > 3 years (0.82 (0.47 to 1.41)), and for long-term mortality in survivors from 30 days (1.02 (0.81 to 1.29)). CONCLUSIONS: When adjusted for differing prevalence of cardiovascular risk factors in the two ethnic groups, survival following AMI was similar for SA and WE patients in the UK.