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Obesity, Diabetes, and Acute Coronary Syndrome: Differences Between Asians and Whites.
- Source :
-
The American journal of medicine [Am J Med] 2017 Oct; Vol. 130 (10), pp. 1170-1176. Date of Electronic Publication: 2017 Apr 08. - Publication Year :
- 2017
-
Abstract
- Background: Most diabetes and cardiovascular studies have been conducted in white patients, with data being extrapolated to other population groups.<br />Methods: For this analysis, patient-level data were extracted from 5 randomized clinical trials in patients with acute coronary syndrome; we compared obesity levels between Asian and white populations, stratified by diabetes status. By using an adjusted Cox proportional hazards model, hazard ratios (HRs) for cardiovascular outcomes after an acute coronary syndrome were determined.<br />Results: We identified 49,224 patient records from the 5 trials, with 3176 Asians and 46,048 whites. Whites with diabetes had higher body mass index values than those without diabetes (median 29.3 vs 27.2 kg/m <superscript>2</superscript> ; P < .0001), whereas Asians with diabetes and without diabetes had similar body mass index (24.7 vs 24.2 kg/m <superscript>2</superscript> ). Asians with diabetes (HR, 1.63; 95% confidence interval [CI], 1.32-2.02), whites with diabetes (HR, 1.15; 95% CI, 1.06-1.25), and Asians without diabetes (HR, 1.36; 95% CI, 1.14-1.64) had higher rates of the composite of death, myocardial infarction, or stroke at 30 days than whites without diabetes. Asians with diabetes (HR, 1.84; 95% CI, 1.47-2.31), whites with diabetes (HR, 1.47; 95% CI, 1.33-1.62), and Asians without diabetes (HR, 1.38; 95% CI, 1.11-1.73) had higher rates of death at 1 year compared with whites without diabetes. There were no significant interactions between race and diabetes for ischemic outcomes.<br />Conclusions: Although Asians with diabetes and acute coronary syndrome are less likely to be obese than their white counterparts, their risk for death or recurrent ischemic events was not lower.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Acute Coronary Syndrome complications
Acute Coronary Syndrome epidemiology
Adult
Aged
Body Mass Index
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 epidemiology
Female
Humans
Male
Middle Aged
Obesity complications
Obesity epidemiology
Risk Factors
Acute Coronary Syndrome ethnology
Asian People statistics & numerical data
Diabetes Mellitus, Type 2 ethnology
Obesity ethnology
White People statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1555-7162
- Volume :
- 130
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The American journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28396226
- Full Text :
- https://doi.org/10.1016/j.amjmed.2017.03.030