Presence of coronary artery disease in diabetic and non diabetic South Asian immigrants

Introduction: South Asian Immigrants (SAls) are the second fastest growing Asian immigrant population in the US, and at a higher risk of type 2 diabetes (diabetes) and coronary artery disease (CAD) than the general US population. Objectives: We sought to determine in SAls the; 1) the prevalence of CAD risk factors in diabetics and non-diabetics; and b) the high possibility of CAD in diabetic SAls. We also assessed the prevalence of sub-clinical CAD in both diabetics and non-diabetics SAls using common carotid artery Intima-media thickness (CIMT) as a surrogate marker for atherosclerosis. Methods: In a cross-sectional study design, 213 first generation SAls were recruited and based on the history, and fasting glucose levels were divided into two subgroups; 35 diabetics and 178 non-diabetics. 12-hour fasting blood samples were collected for glucose and total cholesterol levels. Exercise Tolerance Test (ETT) was performed to determine the possibility of CAD. Results: Both diabetics and non-diabetics SAls in general, share a significant burden of CAD risk factors. The prevalence of hypertension (p = 0.003), total cholesterol > 200 mg/di (p < 0.0001) and family history of diabetes (p < 0.0001) was significantly was significantly higher in diabetics compared to nondiabetics. Of the 22/29 diabetic participants without known history of CAD, 45% had positive ETT (p < 0.001). Similarly, 63.1% of diabetics and 51.8 % of non-diabetics were positive for sub-clinical CAD using CIMT as a marker. Conclusion: The susceptibility to diabetes amongst SAIs promotes an adverse CAD risk, as evident by this small study. Further research, including larger longitudinal prospective studies, is required to validate the current small study findings with investigation of the temporal association. (C) 2017 Published by Elsevier B.V. on behalf of Cardiological Society of India.