3 Survival following acute myocardial infarction in patients of South Asian and White European ethnicity in the UK

Introduction Some UK studies have suggested higher case-fatality rates following acute myocardial infarction (AMI) in British South Asian (SA), compared to white European (WE) people, driven by higher prevalence of diabetes in the SA ethnic group. However other studies have suggested similar or even better adjusted overall post-AMI survival for these ethnic groups. In patients with AMI, both prior diagnosis of diabetes as well as acutely elevated blood glucose regardless of diabetes status are associated with adverse outcomes. The aim of this study was to compare survival rates following AMI in SA and WE patients drawn from a contemporary, multi-ethnic UK population. Methods: We conducted a retrospective cohort study of total 4111 (SA 18%) consecutive patients with AMI admitted between October 2002 and September 2008. Baseline differences between the ethnic subgroups were examined using independent two-sample t tests for continuous and χ 2 tests for categorical variables. Cox regression models were constructed to identify determinants of 30-days and 1-year mortality, entering ethnicity, random admission blood glucose and antecedent diabetes individually and together along with other relevant variables. Results: SA patients were younger (62 vs 67 years, p Conclusions Despite higher prevalence of diabetes in SA patients, their mortality post AMI was similar to WE patients. Furthermore, admission hyperglycaemia more so than antecedent diabetes was an important predictor of increased mortality post AMI. To improve survival, active management of admission hyperglycaemia should be considered in patients admitted with AMI, regardless of their diabetes status or ethnicity.