Evaluation of patient characteristics and utilisation of invasive cardiac procedures in a UK ethnic population with unstable angina pectoris

Objectives: To evaluate patient characteristics and utilisation of invasive cardiac procedures in a UK ethnic population with unstable angina pectoris (UAP). Design: Retrospective, observational study. Setting: Tertiary refer ral cardiology centre in the United Kingdom serving a large Asian ethnic po pulation. Subjects: White and Asian patients undergoing PTCA for UAP over a 2.5-year period at a UK referral cardiology centre from a comprehensive PT CA database. Data were also collated for all emergency admissions with unst able angina, or angina (type unspecified), to our institute. Main outcome m easures: Demographic and angiographic characteristics of patients undergoin g PTCA. Frequency of usage of invasive cardiac procedures was determined in emergency angina admissions. Results: From January 1997 to July 1999, 435 White and 36 Asian patients underwent PTCA for UAP at our institute. Asian patients were on average 4.4 years younger (P = 0.015), had 19.3% more diab etes (P = 0.003) and 19.7% less smoking (P = 0.007). Trends to more single vessel disease in Whites and more double vessel disease in Asians were obse rved, with similar rates of triple vessel disease. Interestingly, Asians al so had trends towards more left-sided coronary artery disease and revascula risation, smaller vessels and less bail-out stenting. Asian patients were s ignificantly less likely to undergo coronary angiography, OR 0.64 (CI 0.45- 0.91, P = 0.012), during the index admission, and showed a trend to less PT CA. Conclusions: Asian patients with unstable angina pectoris appear to hav e clinical and angiographic differences from their White counterparts, and are less likely to have invasive cardiac procedures deployed. The reasons f or these observations require elucidation and the prognostic significance o f these findings is uncertain. (C) 2001 Elsevier Science Ireland Ltd. All r ights reserved.