Wednesday, November 03, 2010


We are still largely dependent on the West to produce medical data for us, or put another way, the data about Asians from the West seemed to be better highlighted in the established medical journals and congresses. Whatever it is, we need data, credible data. We need credible data to plan, we need data to understand clinical trial results and how to advise patients and how to understand risks.
Be that as it may, I picked up a study, done in Canada, and presented at the Canadian Cardiovascular Congress 2010, on South Asians in Ontario, Canada. The study was led by Dr Milan Gupta from the McMaster U, Hamilton, Ontario. He took from the his registry, a cohort of 514 patients, 199 of whom were South Asians ( meaning Indians ) and 315 Whites. He studied their cardiovascular risk factors, which were essentially the same in both groups. Followed them for 5 years, and compare the outcomes in both groups after 5 years. The primary endpoint was cardiovascular death, non-fatal MI, non-fatal strokes and need for re-vascularisation ( basically all the cardiac indices ), and found that in the 5 years, 25.1% of South Asians and 19.7% of Whites met the primary endpoint. Although it did not meet statistical significance ( p was 0.15 ), I am sure it would have been significant if the numbers enrolled were larger. It does appear that South Asians, have a higher CV risk then Whites.
They subsequently studied " Why ? ", and found that their South Asians had a higher PAI ( Plasminogen Activator Inhibitor ) level, or as the locals will say " their blood was thicker ", then the whites, and also there was a higher incidence of the Metabolic Syndrome. Could it be that the higher PAI levels were genetically related and the Metabolic Syndrome and high CVS event rates were due to the high PAI levels? Interesting.
Obviously, we need larger numbers to be sure, but it does give room for more research and also more work to be done, hopefully by us Asians.
Let us all hope that this John Hopkins / College of Surgeons Ireland / Academic University thing that the present government is talking about, will contribute to this end, when or if it comes about.
South Asians, be aware, you are at higher risk for CV events, should you have Metabolic Syndrome and CAD.

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