Physicians in our hospital have observed young patients with severe CAD among the Asian Immigrant population from India, Pakistan and Bangladesh. Our aim was to determine if premature CAD is a characteristic feature of CAD seen in this immigrant population.
Data of all Asian patients who presented to our institution with chest pain or angina equivalent who underwent coronary angiogram from 1998 to 2002 were collected and compared with non Asians during the year 2001. Premature CAD was defined as >70% stenosis of at least one vessel on coronary angiography in males <45 years of age.
Data from 338 Asian patients and 251 non Asian patients was available for evaluation and comparison. Significant CAD was noted in 218/338[64%] Asian patients and in 152/251[60%] in non Asian patients [p>0.3] suggesting no selection bias in performing invasive cardiac work up. Average age of Asian patients with significant CAD was 54±9 years and 64.5±10 years among non Asian patients[p0.001]. Of the 218 Asian patients with CAD 45[21%] had premature CAD compared with only 9 out of 152 [6%] non Asian patients[p<0.05]. Among Asian patients, 9 were less than 40 years of age, and only 1 non Asian patient was less than 40 years of age. Of the 45 Asian patients with premature CAD, 25 needed CABG and 13 needed PTCA/stent, compared to 1 and 6 patient respectively among non Asian patients. Risk factors among Asian patients with premature CAD was smoking 25[57%], HTN 21[45%], DM 11[23%]. The mean total cholesterol was 210±48, mean LDL was 120±39, mean HDL was 36±58, mean triglycerides was 247±156.
Premature severe CAD is a feature of the CAD seen in the immigrant population from India, Pakistan and Bangladesh. No unusual risk factors were noted in this group.
A high index of suspicion for CAD is needed when evaluating young Asian patients presenting to Emergency Room with chest pain or angina equivalent.
U. Patel, None.