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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ECanadians of South Asian ancestry treated with coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) have improved long-term survival but higher rates of repeat revascularization with PCI compared with Canadians of European descent. This article presents data from a study comparing short- and long-term clinical outcomes among Canadians of South Asian and European descent admitted to the hospital with acute coronary syndrome.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECoronary Artery Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECoronary Artery Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ECanadians of South Asian ancestry treated with coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) have improved long-term survival but higher rates of repeat revascularization with PCI compared with Canadians of European descent. Kevin R. Bainey, MD, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada, presented data from a study comparing short- and long-term clinical outcomes among Canadians of South Asian and European descent admitted to the hospital with acute coronary syndrome (ACS).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EWith the growing migration of South Asians to North America, there is an increased need for physicians to be aware of ethnic differences associated with coronary artery disease (CAD) [Bainey KR and Jugdutt BL. \u003Cem\u003EAtherosclerosis\u003C\/em\u003E 2009]. South Asians living in Canada have a greater prevalence of atherosclerosis [Anand SS et al. \u003Cem\u003ELancet\u003C\/em\u003E 2000] and high rates of CAD mortality [Sheth T et al. \u003Cem\u003ECMAJ\u003C\/em\u003E 1999] that occurs at a younger age [Yusuf S et al. \u003Cem\u003ELancet\u003C\/em\u003E 2004]. Canadians of South Asian descent with CAD also have significantly worse health outcomes 1 year after angiography compared with Canadians of European ancestry. One-year adjusted mean (SD) scores were significantly lower in South Asian angina frequency (86 [23] vs 88 [20]), treatment satisfaction (86 [19] vs 89 [16]), and quality of life (71 [24] vs 76 [21]; p\u0026lt;0.001 for all) [Bainey KR et al. \u003Cem\u003EAm Heart J\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe objective of this large, prospective, comprehensive clinical registry study was to compare short- and long-term clinical outcomes of South Asian and European Canadian patients admitted with ACS. A validated names analysis program was used to identify South Asian surnames for patients listed in the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease database, an ongoing prospective data collection initiative that tracks patients having balloon angioplasty, the type and location of coronary artery stents, as well as previous or subsequent revascularization by CABG or PCI. A 3:1 propensity-matched technique was used to reduce variability and improve biased reduction.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EOf the 68,108 patients with ACS undergoing coronary angiography between 1999 and 2012, 1823 were South Asian and 61,260 were of European descent. There were no significant differences in 30-day and 1-year mortality rates, or 1-year repeat angiogram rates between the two groups. Propensity-matched, adjusted, 1-year repeat revascularization rates with PCI were significantly higher for South Asian compared with European patients (6.0% vs 3.6%; p\u0026lt;0.01). There was no difference in 1-year repeat revascularization among patients receiving CABG (4.8% vs 5.6%; p=0.75). Long-term survival for propensity-matched, adjusted ACS patients was significantly higher (p\u0026lt;0.01) for South Asian Canadians (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E) particularly with revascularization.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIt should be noted that the use of name recognition software, versus self-identification, may have resulted in the incorrect assignment of some subjects because of interracial marriage or religious conversion\/name change. In addition, the use of propensity-matched analysis may not control for unmeasured confounders between South Asian and European Canadian patients.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThese data indicate the need for clinicians to be more sensitive to ethnic-based outcomes and therapeutic strategies in the treatment of ACS.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/14\/10\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Comparison of Long-Term Mortality in South Asian and European ACS Patients\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1466105915\u0022 data-figure-caption=\u0022Comparison of Long-Term Mortality in South Asian and European ACS Patients\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/14\/10\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/14\/10\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/14\/10\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13675\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EComparison of Long-Term Mortality in South Asian and European ACS Patients\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from KR Bainey, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/14\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nznnjd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznnjd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}