ANGIOGRAPHIC COMPARISON OF CORONARY-ARTERY DISEASE BETWEEN ASIANS ANDCAUCASIANS

Asians in the United Kingdom surpass the already high mortality from c oronary artery disease seen in Caucasians. In the present study, the a ngiographic features of consecutive series of 87 Caucasians, 83 Britis h Asian and 30 Asian patients in India with coronary artery disease we re assessed. Blood samples at fasting and after ingestion of 75 g of d extrose were taken to assess the extent of diabetes. Fasting blood sam ples mere also taken for measurement of cholesterol, high-density lipo protein cholesterol and triglyceride. Coronary angiograms were scoped by two independent observers who were blinded to the patients' ethnic origin. The Asians were younger than the Caucasians, but did not diffe r in their body mass index, systolic or diastolic blood pressure or in cigarette consumption. Lipids were similar apart from Indian Asians h aving lower cholesterol than British Asians, and Caucasians having low er triglyceride than Asians. There were more diabetics in Asians than in Caucasians. Asians in Britain wait longer than Caucasians and Asian s in India from onset of angina to undergoing coronary angiography. Th e presence of triple vessel disease was not significantly different (P = 0.19) in the three groups, that is, 38%, 43% and 27% in Caucasians, British Asians and Indian Asians, respectively. The geometric mean co ronary score was 26.3 (C.I. 22.6-30.6), 25.3 (C.I. 21.8-29.4), and 25. 2 (C.I. 19.6-32.5) in Caucasians, British Asians and Indian Asians, re spectively. This difference was not significant (P = 0.92). Total numb er of lesions more than three were similar, that is, in 25% Caucasian, 41% British Asian and 40% Indian Asian patients (P < 0.10). British A sians had less proximal disease (P = 0.0002), and Indian Asians less d istal disease (P = 0.003) compared to Caucasians. Non-discrete (long) lesions were more prevalent in Asians than Caucasians (P = 0.0005). Th e total number of lesions more than three in diabetic Asians was signi ficantly more than in the non-diabetic, 71% versus 31% in British Asia ns (P = 0.002) and 90% versus 15% in Indian Asians (P = 0.0001). The r elationship between diabetes and long lesions in both British and Indi an Asians was highly significant (P < 0.00001 and P < 0.001, respectiv ely). Thus severity and extent of coronary disease is no different in Asians as compared to Caucasians. Diabetes is perhaps responsible for the more diffuse disease seen in Asians.