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Muscoli S, Andreadi A, Tamburro C, Russo M, Rosenfeld R, Oro P, Ifrim M, Porzio F, Barone L, Barillà F, Lauro D. Prevalence of Cardiovascular Risk Factors and Coronary Angiographic Findings in High-Risk Immigrant Communities in Italy. J Pers Med 2023; 13:882. [PMID: 37373871 DOI: 10.3390/jpm13060882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The prevalence of coronary artery disease (CAD) considerably varies by ethnicity. High-risk populations include patients from Eastern Europe (EEP), the Middle East and North Africa (MENAP) and South Asia (SAP). METHODS This retrospective study aims to highlight cardiovascular risk factors and specific coronary findings in high-risk immigrant groups. We examined the medical records and coronary angiographies of 220 patients from the above-mentioned high-risk ethnic groups referred for Acute Coronary Syndrome (ACS) and compared them with 90 Italian patients (IP) from 2016 to 2021. In the context of high-risk immigrant populations, this retrospective study aims to shed light on cardiovascular risk factors and particular coronary findings. We analyzed the medical records of 220 patients from the high-risk ethnic groups described above referred for ACS and compared them with 90 IPs between 2016 and 2021. In addition, we assessed coronary angiographies with a focus on the culprit lesion, mainly evaluating multi-vessel and left main disease. RESULTS The mean age at the first event was 65.4 ± 10.2 years for IP, 49.8 ± 8.5 years for SAP (Relative Reduction (ReR) 30.7%), 51.9 ± 10.2 years for EEP (ReR 26%) and 56.7 ± 11.4 years for MENAP (ReR 15.3%); p < 0.0001. The IP group had a significantly higher prevalence of hypertension. EEP and MENAP had a lower prevalence of diabetes. EEP and MENAP had a higher prevalence of STEMI events; SAP showed a significant prevalence of left main artery disease (p = 0.026) and left anterior descending artery disease (p = 0.033) compared with other groups. In SAP, we detected a higher prevalence of three-vessel coronary artery disease in the age group 40-50. CONCLUSIONS Our data suggest the existence of a potential coronary phenotype in several ethnicities, especially SAP, and understate the frequency of CV risk factors in other high-risk groups, supporting the role of a genetic influence in these communities.
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Affiliation(s)
- Saverio Muscoli
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Aikaterini Andreadi
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
- Division of Endocrinology and Diabetology, Department of Medical Sciences, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Claudia Tamburro
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Massimo Russo
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Roberto Rosenfeld
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Pietro Oro
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Mihaela Ifrim
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Federica Porzio
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Lucy Barone
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Francesco Barillà
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Davide Lauro
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
- Division of Endocrinology and Diabetology, Department of Medical Sciences, Fondazione Policlinico "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
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Satish P, Vela E, Bilal U, Cleries M, Kanaya AM, Kandula N, Virani SS, Islam N, Valero-Elizondo J, Yahya T, Comin-Colet J, Nasir K, Mauri J, Cainzos-Achirica M. Burden of cardiovascular risk factors and disease in five Asian groups in Catalonia: a disaggregated, population-based analysis of 121 000 first-generation Asian immigrants. Eur J Prev Cardiol 2022; 29:916-924. [PMID: 33969397 PMCID: PMC9793716 DOI: 10.1093/eurjpc/zwab074] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/07/2021] [Accepted: 04/18/2021] [Indexed: 12/30/2022]
Abstract
AIMS To evaluate the burden of cardiovascular risk factors and disease (CVD) among five Asian groups living in Catalonia (Spain): Indian, Pakistani, Bangladeshi, Filipino, and Chinese. METHODS AND RESULTS Retrospective cohort study using the Catalan Health Surveillance System database including 42 488 Pakistanis, 40 745 Chinese, 21 705 Indians, 9544 Filipinos, and 6907 Bangladeshis; and 5.3 million native individuals ('locals'). We estimated the age-adjusted prevalence (as of 31 December 2019) and incidence (during 2019) of diabetes, hypertension, hyperlipidaemia, obesity, tobacco use, coronary heart disease (CHD), cerebrovascular disease, atrial fibrillation, and heart failure (HF). Bangladeshis had the highest prevalence of diabetes (17.4% men, 22.6% women) followed by Pakistanis. Bangladeshis also had the highest prevalence of hyperlipidaemia (23.6% men, 18.3% women), hypertension among women (24%), and incident tobacco use among men. Pakistani women had the highest prevalence of obesity (28%). For CHD, Bangladeshi men had the highest prevalence (7.3%), followed by Pakistanis (6.3%); and Pakistanis had the highest prevalence among women (3.2%). For HF, the prevalence in Pakistani and Bangladeshi women was more than twice that of locals. Indians had the lowest prevalence of diabetes across South Asians, and of CHD across South Asian men, while the prevalence of CHD among Indian women was twice that of local women (2.6% vs. 1.3%). Filipinos had the highest prevalence of hypertension among men (21.8%). Chinese men and women had the lowest prevalence of risk factors and CVD. CONCLUSIONS In Catalonia, preventive interventions adapted to the risk profile of different Asian immigrant groups are needed, particularly for Bangladeshis and Pakistanis.
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Affiliation(s)
- Priyanka Satish
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St Brown Bldg. B5-019, Houston, TX 77030, USA
| | - Emili Vela
- Healthcare Information and Knowledge Unit, Catalan Health Service, Travessera de les Corts, 131-159 - Pavelló Ave Maria; 08028 Barcelona, Spain,Pla Director de Malalties de l’Aparell Circulatori (PDMAC), Health Department of the Government of Catalonia, Travessera de les Corts, 131-159 - Pavelló Ave Maria; 08028 Barcelona, Spain
| | - Usama Bilal
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Nesbitt Hall, 3215 Market St, Philadelphia, PA 19104, USA
| | - Montse Cleries
- Healthcare Information and Knowledge Unit, Catalan Health Service, Travessera de les Corts, 131-159 - Pavelló Ave Maria; 08028 Barcelona, Spain,Pla Director de Malalties de l’Aparell Circulatori (PDMAC), Health Department of the Government of Catalonia, Travessera de les Corts, 131-159 - Pavelló Ave Maria; 08028 Barcelona, Spain
| | - Alka M. Kanaya
- Department of Medicine, University of California, San Francisco (CA), 505 Parnassus Ave, San Francisco, CA 94143, USA
| | - Namratha Kandula
- Feinberg School of Medicine, Northwestern University, Chicago(IL), 303 E Chicago Ave, Chicago, IL 60611, USA
| | - Salim S. Virani
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center and Section of Cardiology, Department of Medicine, Baylor College of Medicine, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Nadia Islam
- Department of Population Health, NYU Langone Health, 550 1st Avenue, New York, NY 10016, USA
| | - Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St Brown Bldg. B5-019, Houston, TX 77030, USA,Center for Outcomes Research, Houston Methodist, 6670 Bertner Ave, Houston, TX 77030, USA
| | - Tamer Yahya
- Center for Outcomes Research, Houston Methodist, 6670 Bertner Ave, Houston, TX 77030, USA
| | - Josep Comin-Colet
- Pla Director de Malalties de l’Aparell Circulatori (PDMAC), Health Department of the Government of Catalonia, Travessera de les Corts, 131-159 - Pavelló Ave Maria; 08028 Barcelona, Spain,Department of Cardiology, Bellvitge University Hospital, Carrer de la Feixa Llarga, s/n, 08907, L’Hospitalet de Llobregat, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Gran Via de les Corts Catalanes, 585, 08007 Barcelona, Spain
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St Brown Bldg. B5-019, Houston, TX 77030, USA,Center for Outcomes Research, Houston Methodist, 6670 Bertner Ave, Houston, TX 77030, USA
| | - Josepa Mauri
- Pla Director de Malalties de l’Aparell Circulatori (PDMAC), Health Department of the Government of Catalonia, Travessera de les Corts, 131-159 - Pavelló Ave Maria; 08028 Barcelona, Spain,Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, s/n, 08916 Badalona, Barcelona, Spain
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St Brown Bldg. B5-019, Houston, TX 77030, USA,Center for Outcomes Research, Houston Methodist, 6670 Bertner Ave, Houston, TX 77030, USA,Corresponding author. Tel: +1 443 413 6350,
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Satish P, Sadaf MI, Valero-Elizondo J, Grandhi GR, Yahya T, Zawahir H, Javed Z, Mszar R, Hanif B, Kalra A, Virani S, Cainzos-Achirica M, Nasir K. Heterogeneity in cardio-metabolic risk factors and atherosclerotic cardiovascular disease among Asian groups in the United States. Am J Prev Cardiol 2021; 7:100219. [PMID: 34611645 PMCID: PMC8387290 DOI: 10.1016/j.ajpc.2021.100219] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/27/2021] [Accepted: 06/13/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The Asian American population in the U.S. comprises various, ethnically diverse subgroups. Traditionally, this population has been studied as a single, aggregated group, potentially masking differences in risk among subgroups. Analyses using disaggregated data can help better characterize the health needs of different Asian subpopulations and inform targeted, effective public health interventions. We assessed the prevalence of cardiovascular disease (CVD) risk factors and atherosclerotic CVD (ASCVD) and their associations with socioeconomic factors among Chinese, Asian Indian, Filipino and Other Asian subjects, compared with non-Hispanic White (NHW) subjects in the U.S. METHODS : Cross-sectional study using data from 298,286 adults from the National Health Interview Survey (NHIS) from 2007 to 2018. We utilized chi-squared tests to compare characteristics across subgroups. Weighted proportions and unadjusted and adjusted logistic regression models were utilized to examine the associations between Asian subgroups, self-reported CVD risk factors and self-reported ASCVD, as well as between socioeconomic factors within each Asian subgroup. RESULTS : Asian Indian subjects had the highest prevalence of diabetes (12.5%), while Filipino subjects had the highest prevalence of hyperlipidemia (27.7%), hypertension (29.8%) and obesity (19.8%). Despite this, the prevalence of self-reported ASCVD was lower in all Asian groups compared with NHWs. Chinese subjects had the lowest odds of having each of the CVD risk factors assessed. CONCLUSION : We found considerable heterogeneity in the distribution of risk factors as well as ASCVD among Asian subgroups in the US. Compared with health system or community-based reports, the prevalence of risk factors and ASCVD may be underestimated in some Asian NHIS subgroups. There is an urgent need for efforts to improve recruitment of Asian participants of heterogeneous socioeconomic backgrounds in national surveys, as well as to perform a thorough assessment of risk factors and disease in this population, not relying solely on self-report.
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Affiliation(s)
- Priyanka Satish
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
| | - Murrium I. Sadaf
- Yale New Haven Medical Center (Waterbury) Internal Medicine Residency Program, Waterbury, CT, United States
| | - Javier Valero-Elizondo
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, United States
| | - Gowtham R. Grandhi
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, United States
| | - Tamer Yahya
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
| | - Hassan Zawahir
- Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
| | - Zulqarnain Javed
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, United States
| | - Reed Mszar
- Yale/YNHH Center for Outcomes Research and Evaluation, New Haven, CT, United States
| | - Bashir Hanif
- Dean, Faculty of Cardiology, College of Physicians and Surgeons Pakistan (CPSP), Pakistan
| | - Ankur Kalra
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH, United States
| | - Salim Virani
- Section of Cardiovascular Research, Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, United States
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, United States
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