Prevalence of cardiovascular risk factors and coronary artery events between immigrant patients from south-east asia and south italian patients with acute coronary syndrome

Aims: The aim of this study is trying to better define determinants of the greatest risk of coronary events in Asian patients compared with south Italian group. In every patient we evaluate the incidence of risk factors, the extent of coronary artery disease and the incidence of major cardiovascular adverse events (MACE) after followup (average of 36 months). Methods and Results: In this study, 56 patients with Acute coronary syndrome (ACS) from south-east Asia were recruited, originating mainly from Bangladesh, India and Sri Lanka, hospitalized between 2013 and 2018. In the study, we compared the characteristics of the Asian population with a control group made up of 56 Sicilian patients who were also hospitalized for ACS in the same period. The demographic, clinical and procedural characteristics were analyzed by consulting an electronic archive. The incidence of MACE was assessed by 36-month follow-up, analyzing the namely death, re-ima, angina and possible death from non-cardiovascular events. The group of Asian patients (88% of males and 13% of females) have an age of 48 years whereas the control group of Italian patients (82% of males and 18% of females) have an average age of 58. In the assessment of risk factors, we observed a significant difference in incidence regarding obesity, in fact only 5% of Asians are obese despite 88% of Italian patients. It is also possible to highlight a higher incidence of type 2 diabetes mellitus in Asians, an expression of a greater predisposition to insulin resistance. Remarkable is the difference between smokers, more Italian than the Asians (77% vs 36%). We also focused our attention on coronary angiography, studying vessels with critical stenoses (occlusion of the lumen greater than 70%) and comparing the data of the two populations. With reference to coronary stenoses, it is noted that in the group of Asian patients, the multiple lesions are 36%, while in Italian patients the multiple lesions result to be 50%. Finally, we compared the incidence of major cardiovascular adverse events (MACE) with a mean follow-up of 36 months comparing the two populations. In Asian patients, 75% had new episodes of angina, 4% had a heart attack, 17% died from a cardiovascular cause, while mortality due to ‘other’ causes was not confirmed. In the group of Italian patients only 8% of patients had angina, while none had a re-heart attack or death. Conclusion: From our study we can see an important prognostic difference between Asian patients and Italian patients in a medium follow up. Therefore, it is advisable to pay attention to the different impact of cardiovascular risk factors and to the need to ensure surveillance of the health status of minorities present in the Europe country, to guarantee a better adherence to therapy and positively change the burden of cardiovascular disease