Risk Factors Associated with Acute Coronary Syndromes in South African Asian Indian Patients [The AIR Study]

Abstract

Aims: To examine the association between traditional risk factors and acute coronary syndrome [ACS] in the South Asian Indian population in KwaZulu Natal, South Africa. Methods and Results: The study population comprised 4418 patients [mean age 54.6+/-10.9 years], of whom 67% were males. The majority presented with ST-elevation myocardial infarction [75%], non ST-elevation myocardial infarction [16%], and 9% unstable angina. Visceral obesity [82%, mean waist circumference 101.43+/-10.34 cm] was the most commonly observed risk factor, while 78% had hypercholesterolaemia [mean 5.97+/-1.11 mmol/L] and 74% a family history of vascular disease [FHVD]. More males compared to females were smokers [p < 0.0001], while females were more likely to have visceral obesity, diabetes, hypertension, increased body mass index, and low high-density lipoprotein cholesterol levels [p < 0.0001]. Young patients [ < 0.0001], and hypertriglyceridaemia [62%, p=0.014] compared to middle [46 - 65 years, n=2708] or old age [> 65 years, n=742] groups, whilst older patients were more likely to have diabetes [59%, p=0.001], and hypertension [68%, p=<0.0001]. Conclusion(s): Asian Indians in South African have multiple risk factors for acute coronary syndrome, possibly contributing to the increased incidence of coronary heart disease at a young age. A FHVD emerged as an important contributor to disease aetiology and should be incorporated in future risk factor analyses. (Table presented).