Author + information
- Naoki Misumida,
- Gbolahan Ogunbayo,
- Odunayo Olorunfemi,
- Ayman Elbadawi and
- Deola Saheed
Background: It has been suggested that Asians are more susceptible to bleeding and stroke events when treated with antiplatelets, anticoagulants and thrombolytic agents. However, the association between Asian ethnicity and bleeding risk in patients with ST-elevation myocardial infarction (STEMI) has not been clarified. We aimed to investigate the association between Asian ethnicity and the rate of blood transfusion in STEMI population using a large national inpatient database.
Methods: We analyzed the 1998 to 2013 Nationwide Inpatient Sample Database and identified all patients older than 18 years hospitalized with a primary diagnosis of STEMI. Patients with Asian or Pacific Islander (Asian) and White were included in the analysis. Baseline characteristics and outcomes such as blood transfusion and in-hospital death were compared between Asian and White groups. Multivariate logistic regression analysis was used to evaluate the risk-adjusted rate of blood transfusion and in-hospital mortality.
Results: Of 707,250 patients with STEMI, 13,688 were Asians (1.9%) and 570,939 were White (80.7%). Asian patients had a higher prevalence of hypertension, diabetes and chronic kidney disease and a lower prevalence of obesity than White population. Asian patients had a lower rate of percutaneous coronary intervention than White patients (46.9% vs. 48.5%, p<0.001). There was no statistically significant difference in the rate of coronary bypass surgery (9.1% vs. 8.7%, p=0.11). Asian patients had a significantly higher rate of blood transfusion (9.3% vs. 5.2%, p<0.0001), hemorrhagic stroke (0.4% vs. 0.3%, p=0.003) and in-hospital mortality (10.8% vs. 10.1%, p=0.01) than White patients. Multivariate logistic regression analysis revealed that Asian ethnicity was an independent predictor for blood transfusion (odds ratio 1.71; 95% confidence interval 1.60-1.82; p<0.001) but not for in-hospital mortality (odds ratio 1.02; 95% confidence interval 0.95-1.09; p=0.49).
Conclusions: Asian patients had a significantly higher rate of blood transfusion compared to White patients. Asian ethnicity was an independent predictor for blood transfusion in patients with STEMI.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-318
- 2017 American College of Cardiology Foundation