Coronary heart disease in Filipino and Filipino-American patients: Prevalence of risk factors and outcomes of treatment

Background Very little has been published on Filipino (F) or Filipino-Ameri can (FA) health, Nothing has been mitten about coronary risk factors and th eir relationship to outcomes of percutaneous coronary intervention or cardi ac surgical treatment in this group. The purpose of this study was to analy ze prospectively. collected data at a center treating coronary artery disea se in a large series of Filipmo patients. Methods. From January 1, 1992 to December 1, 1996, 527 consecutive FA patie nts and 3,176 Caucasians (C) were identified from an ongoing cardiac databa se. In-hospital and late outcomes post discharge were evaluated and results between the FA and C groups were compared, Results. The FA population had a higher incidence of hypertension (79% vs, 61%, p < 0.0001) and diabetes (34.7% vs. 24.1%, p < 0.001) compared to C pa tients. Hypercholesterolemia was similar in both groups. Obesity (FA 12.2% vs. C 18.3%, p < 0.0001) and current smoking (FA 15.8% vs. C 21.5% p < 0.00 1) were more common in the C patients. Age at presentation did not differ b etween groups. Morbidity and mortality were higher in the FA patients follo wing intervention in the catheterization lab (4.2% vs. 1.3%, p < 0.01). Log istic regression showed that FA ethnicity was an independent predictor of d eath after catheterization laboratory intervention (p < 0.01), along with e mergency procedure, depressed ejection fraction, history of myocardial infa rction (MI) and age greater than 65. For coronary bypass surgery, mortality and rate of MI was similar in both groups. Late follow-up post discharge ( mean 17 months, range 12-68) was obtained on 90%, and 89% of eligible FA an d C patients, respectively. Occurrence of late death and RH did not differ between the groups. However, need for any reintervention (catheterization l aboratory or surgical) was significantly higher in the FA patients (21.2% v s. 14.9% (p < 0.001). Cox praportional hazard regression modeling showed th at FA ethnicity was an independent predictor of need for late reinterventio n (p < 0.01), along with type of initial treatment, history of diabetes, pr esence of triple vessel disease, initial presentation with acute MI and age greater than 65. Conclusion. Filipino-Americans have a higher prevalence of hypertension and diabetes, and a lower prevalence of smoking and obesity compared to Caucas ians, FA ethnicity is an independent predictor of higher mortality after ca theterization laboratory intervention and increased need for late reinterve ntion. However, the rate of late MI and death in FA was similar to C patien ts. These results suggest that FA patients, especially these presenting wit h diabetes for CAD treatment, need to be followed closely after percutaneou s intervention or cardiac surgery procedures.