A comparison of Chinese and non-Chinese Canadian patients hospitalized with heart failure

Darwin F Yeung,Baiju R Shah,Nicole K Van Dyke,Gordon W Moe,Jack V Tu,Ching Lau,Douglas S Lee,Laura C Maclagan,Dennis T Ko,Maria Chiu

doi:10.1186/1471-2261-13-114

Abstract

BackgroundCanadians of Chinese descent, represent one of the fastest growing visible minority groups in Canada, (as well as the second largest), but relatively little is known about the clinical features of heart failure (HF) in Chinese-Canadian versus non-Chinese Canadian patients.MethodsWe conducted a population-based analysis of urban patients hospitalized in Ontario, Canada for the first time with a most responsible diagnosis of HF between April 1, 1995 and March 31, 2008. Among the 99,278 patients, 1,339 (1.3%) were classified as Chinese using a previously validated list of Chinese surnames. Through linkage to other administrative databases, we compared the clinical characteristics, pharmacological management, and outcomes of Chinese versus non-Chinese HF patients.ResultsIschemic heart disease was identified as the possible etiology of HF in a greater proportion of non-Chinese patients (47.7% vs. 35.3%; p < 0.001) whereas hypertension (26.1% vs. 16.1%; p < 0.001) and valvular heart disease (11.6% vs. 7.2%; p < 0.001) were relatively more common in Chinese patients. Chinese patients were prescribed angiotensin-converting enzyme (ACE) inhibitors less frequently (57.5% vs. 66.4%, p < 0.001) and angiotensin receptor blockers (ARBs) more frequently (17.4% vs. 8.9%, p < 0.001) compared to non-Chinese patients. They were also less likely to be adherent to ACE inhibitors over a 1-year follow up period. However, the 1-year case-fatality rates were comparable between the Chinese (31.7%) and non-Chinese (30.2%) subjects (p = 0.24).ConclusionThere are important differences in the causes and medical management of HF in Chinese and non-Chinese patients residing in Canada. Despite these differences, the long-term outcomes of HF patients were similar.

Highlights

Canadians of Chinese descent, represent one of the fastest growing visible minority groups in Canada, but relatively little is known about the clinical features of heart failure (HF) in Chinese-Canadian versus non-Chinese Canadian patients
Chinese Canadians constitute 4.7% of the Ontario population and represent 21% of its visible minority [2] population and yet, little is known about the clinical features of HF in Chinese patients, relative to other Canadians
Clinical characteristics We identified 99,278 patients residing in an urban area who were hospitalized in Ontario for the first time with a most responsible diagnosis of HF from April 1, 1995 to March 31, 2008

Summary

Introduction

Canadians of Chinese descent, represent one of the fastest growing visible minority groups in Canada, (as well as the second largest), but relatively little is known about the clinical features of heart failure (HF) in Chinese-Canadian versus non-Chinese Canadian patients. In a retrospective study of 404 Chinese patients and 1,129 white patients referred to an urban tertiary care cardiology clinic outcomes of Chinese and non-Chinese patients in a large population-based cohort of HF patients in Ontario, Canada. It builds upon previous studies which focused predominantly on incidence or mortality outcomes alone

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Discussion

Conclusion