Asian Indians present earlier compared to Caucasians with myocardial infarction (MI). Studies have been done in this regard. Aim of this study is to evaluate ethnic differences for coronary artery disease (CAD) when patients present with MI earlier than 55 years.
Retrospective study (1995–2008) evaluating differences in the age of presentation, gender and traditional risk factors for CAD in all patients presenting with MI who were 55 years or younger at a community hospital.
We analyzed a total of 752 patients who presented over 14 years (M: 87%). Two most predominant groups were people of Indian subcontinent origin (Group I; n = 132 [17.5%]; M: 92%) and Caucasians (Group C; n = 447 [82.5%]; M: 87%). Group I presented at a significantly earlier age compared to Group C (45+/− 5.5 yrs vs. 48 +/− 5.8 yrs; p < 0.0001). There was no difference in the prevalence of triple vessel disease, hypertension, diabetes mellitus, dyslipidemia, smoking or family history of CAD between the 2 groups. Regardless of ethnicity, patients with metabolic syndrome had a significantly higher incidence of triple vessel disease. When comparing gender differences the incidence of triple vessel disease was similar in both genders. Women had a higher incidence of diabetes mellitus (F: 37.8%; M: 23.7%; p = 0.005), hypertension (F: 63.8%; M: 48.5%; p = 0.008) and obesity (F: 50.5%; M: 40%; p = 0.05).
Among patients younger than 55 years, people of Indian origin still present earlier with MI when compared to Caucasians. Women less than 55 years having MI had the same incidence of triple vessel disease as men. This could be due to higher prevalence of metabolic syndrome in women.
Asian Indians present with MI earlier than caucasians even when risk factors are similar. This could be due to inadequate preventive care or other as yet unexplored genetic factors. Also metabolic syndrome can nullify the cardio-protective effect of estrogen in younger women, hence, it is imperative to aggressively treat it in pre-menopausal young women.
Ankur Lodha, No Financial Disclosure Information; No Product/Research Disclosure Information