PT204 Incidence of Clopidogrel Resistence in South Asians and the Impact of Balloon Inflation on Platelet Inhibition in Blood Samples obtained from Guide Cathters: Comparison of Clopidogrel with Prasugrel in a South Asian Population presenting with Acute Coronary Syndrome

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e207-e208
Author(s):  
Chowdhury H. Ahsan ◽  
M.A. Rashid ◽  
Saidur R. Khan ◽  
Rezaul M. Karim ◽  
M. Maksumul Haq
Keyword(s):  
Acute Coronary Syndrome ◽  
South Asian ◽  
South Asians ◽  
Asian Population ◽  
Platelet Inhibition ◽  
Balloon Inflation ◽  
South Asian Population ◽  
Blood Samples ◽  
Coronary Syndrome ◽  
The Impact

Effects of clopidogrel vs. prasugrel vs. ticagrelor on endothelial function, inflammatory parameters, and platelet function in patients with acute coronary syndrome undergoing coronary artery stenting: a randomized, blinded, parallel study

2020 ◽  
Vol 41 (33) ◽  
pp. 3144-3152 ◽  
Author(s):  
Boris Schnorbus ◽  
Andreas Daiber ◽  
Kerstin Jurk ◽  
Silke Warnke ◽  
Jochem Koenig ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Endothelial Function ◽  
Adenosine Diphosphate ◽  
Platelet Inhibition ◽  
Clinical Parameter ◽  
Mean Difference ◽  
Low Flow ◽  
Flow Mediated Dilation ◽  
Coronary Syndrome ◽  
The Impact

Abstract Aims In a randomized, parallel, blinded study, we investigate the impact of clopidogrel, prasugrel, or ticagrelor on peripheral endothelial function in patients undergoing stenting for an acute coronary syndrome. Methods and results The primary endpoint of the study was the change in endothelium-dependent flow-mediated dilation (FMD) following stenting. A total of 90 patients (age 62 ± 9 years, 81 males, 22 diabetics, 49 non-ST elevation myocardial infarctions) were enrolled. There were no significant differences among groups in any clinical parameter. Acutely before stenting, all three drugs improved FMD without differences between groups (P = 0.73). Stenting blunted FMD in the clopidogrel and ticagrelor group (both P < 0.01), but not in the prasugrel group. During follow-up, prasugrel was superior to clopidogrel [mean difference 2.13, 95% confidence interval (CI) 0.68–3.58; P = 0.0047] and ticagrelor (mean difference 1.57, 95% CI 0.31–2.83; P = 0.0155), but this difference was limited to patients who received the study therapy 2 h before stenting. Ticagrelor was not significantly superior to clopidogrel (mean difference 0.55, 95% CI −0.73 to 1.82; P = 0.39). No significant differences were seen among groups for low-flow-mediated dilation. Plasma interleukin (IL)-6 (P = 0.02 and P = 0.01, respectively) and platelet aggregation reactivity in response to adenosine diphosphate (P = 0.002 and P = 0.035) were lower in the prasugrel compared to clopidogrel and ticagrelor group. Conclusion As compared to ticagrelor and clopidogrel, therapy with prasugrel in patients undergoing stenting for an acute coronary syndrome is associated with improved endothelial function, stronger platelet inhibition, and reduced IL-6 levels, all of which may have prognostic implications. This effect was lost in patients who received the study medication immediately after stenting. EUDRACT-No 2011-005305-73

scholarly journals Nutrition in an ethnically diverse society: what are some of the key challenges?

2011 ◽  
Vol 70 (2) ◽  
pp. 252-262 ◽  
Author(s):  
Ala Szczepura
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Ethnic Minority ◽  
South Asian ◽  
South Asians ◽  
Asian Population ◽  
Minority Populations ◽  
Diverse Population ◽  
South Asian Population ◽  
Ethnic Minority Populations

The role of nutrition is especially important in certain ‘lifestyle’ diseases that impact disproportionately on ethnic minority populations. The aim of this paper is to review the evidence of risk, health outcomes and interventions for certain diseases that affect the UK's largest ethnic minority group (South Asians) in order to help professionals better address the needs of this diverse population. Research evidence is presented on factors influencing access to services by ethnic minority populations and the changing UK policy background for public health and preventive care. The available research base on obesity, diabetes and CVD is discussed. Conditions such as type 2 diabetes, which are more prevalent among the South Asian population, are associated with poorer health outcomes and appear to exhibit links to diet and nutrition that start in childhood or even before birth; all making preventive care important. Obesity is a major risk factor and it appears that BMI thresholds may need to be lower for South Asians. Targeted interventions to improve diet and outcomes in the South Asian population also appear promising. Recent moves to promote access to evidence of ethnicity and health and to improve the cultural competence of organisations are discussed. Health professionals will increasingly need to promote lifestyle changes in a manner that meets the needs of a diverse population in order to address future public health challenges. Nutritionists and other professionals will need to ensure that interventions are culturally appropriate and involve engagement with extended family members and communities.

Gender-Associated Perceptions of Barriers and Motivators to Physical Activity Participation in South Asian Punjabis Living in Western Canada

2015 ◽  
Vol 12 (5) ◽  
pp. 686-693 ◽  
Author(s):  
Cristina M. Caperchione ◽  
Shirley Chau ◽  
Gordon J. Walker ◽  
W. Kerry Mummery ◽  
Cally Jennings
Keyword(s):  
Physical Activity ◽  
South Asian ◽  
South Asians ◽  
Asian Population ◽  
Work And Family ◽  
Computer Assisted ◽  
South Asian Population ◽  
Chi Square ◽  
Chi Square Analysis ◽  
Barriers And Motivators

Background:Gender is a sociocultural factor known to impact the physical activity (PA) behaviors of South Asians. The purpose of this research was to examine gender-associated perceptions of barriers and motivators for PA in a South Asian population living Canada.Methods:A random sample (N = 204) of South Asian Punjabi adults (18yrs+) completed a computer assisted telephone interview concerning their perceptions to PA participation. Content analysis was used to identify relevant main themes and chi-square analysis was used to calculate gender differences.Results:Results indicated that women more often reported a lack of time due to work and family (χ2 = 7.284, df = 1, P = .007) and a lack of motivation (χ2 = 4.982, df = 1, P = .026), yet men more often reported climate (χ2 = 7.045, df = 1, P = .008) as a barrier. Regarding motivators, men more often reported prevention and reduction of disease (χ2 = 4.451, df = 1, P = .034) and watching others perform (χ2 = 10.827, df = 1, P = .001); however, reducing weight gain (χ2 = 4.806, df = 1, P = .028) and looking like others (χ2 = 4.730, df = 1, P = .029) were reported more often by women.Conclusions:Gender-associated differences concerning PA are present in this population and must be considered in the design and implementation of effective interventions.

Abstract P472: Addressing Hypertension and Cardiovascular Disease in South Asian San Joaquin Population

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Maha Siddiqui
Keyword(s):  
Blood Pressure ◽  
At Risk ◽  
South Asian ◽  
Low Income ◽  
South Asians ◽  
Asian Population ◽  
The South ◽  
South Asian Population ◽  
Asian Community ◽  
South Asian Community

Introduction: South Asians have a higher death rate than any other population for cardiovascular disease (CVD) and high blood pressure (HBP). San Joaquin has a growing rate of South Asians immigrants who may be at risk for CVD. Objectives: Trainees conducted hypertension and CVD screenings at South Asians religious organizations to reduce the risk of CVD and spread awareness about the factors that lead to CVD and its implications in the South Asians population due to environmental racism in the most underserved county for health care, San Joaquin. Methods: I trained low-income minority high school students to conduct weekly blood pressure screenings and serve as a health technology coach by each student monitoring 2 hypertensive patients of 48 hypertensive or at risk hypertensive and low-income San Joaquin residents and constantly stressed, and at risk for CVD. CVD screenings were conducted at all San Joaquin gurdwaras and mosques to spread awareness about heart health and track hypertension in the South Asians community. Findings: -61.7% of the South Asian population of San Joaquin are at risk for CVD -3.3% of the South Asian population of San Joaquin are hypotensive -28.6% of the South Asian population of San Joaquin are Stage 1 hypertensive -29.7% of the South Asian population of San Joaquin are Stage 2 hypertensive -38.3% of the South Asian population of San Joaquin have normal blood pressure but consume red meat more than 4 times a month Direct Outcomes of Events: -Development of self-advocacy in the South Asian community. Community members became activists for their own heart health. -Increased participation of youth, in an otherwise adult dominant environment (i.e. the mosques and gurdwaras). -Increased awareness of CVD, hypertension, hypotension, and periodontal disease (PD) among the South Asian community. -Increased participation by youth and adults on activities such as games, challenges and information booths dispensing awareness on CVD and PD. -Increased interaction between community members of different religions, creed, and socioeconomic backgrounds. -Awareness, education among the South Asian community for better heart and oral health -Diagnoses and referrals of suspected cases of hypertension and CVD -Improved patient-provider trust -San Joaquin high school students trained for community outreach events and determined to address CVD. -Youth learned the value of empathy, multiculturalism, and service to disadvantaged communities through the program and volunteering.

scholarly journals Oral Health Beliefs, Attitudes, and Practices of South Asian Migrants: A Systematic Review

2019 ◽  
Vol 16 (11) ◽  
pp. 1952 ◽  
Author(s):  
Mehak Batra ◽  
Sabrina Gupta ◽  
Bircan Erbas
Keyword(s):  
Oral Health ◽  
Health Beliefs ◽  
South Asian ◽  
Health Knowledge ◽  
South Asians ◽  
Country Of Origin ◽  
Asian Population ◽  
South Asian Population ◽  
Attitudes And Practices ◽  
The Uk

Oral health is a burden among all populations and is linked with major chronic diseases such as cardiovascular diseases. Migrants, in particular South Asians, have poor oral health which requires further understanding to better inform oral health interventions by targeting specific aspects of this heterogenous South Asian population. This review is undertaken to systematically synthesize the evidence of oral health understandings, knowledge, attitudes, beliefs, practices, and behaviors of South Asian migrants residing in high-income countries. A comprehensive systematic search of seven electronic databases and hand-searching for peer-reviewed studies was conducted. All study designs were included, and quality assessment conducted. Of the 1614 records identified, 17 were included for synthesis and 12 were quantitative in design. These studies were primarily conducted in the UK, USA, Canada, and Europe. South Asian migrants had inadequate oral health knowledge, attitudes, and practices—influenced by culture, social norms, and religiosity. In the absence of symptoms, preventive oral hygiene practices were limited. Barriers to access varied with country of origin; from lack of trust in dentists and treatment cost in studies with India as the country of origin, to religiosity, among poorer nations such as Bangladesh. Fewer studies focused on recent arrivals from Bhutan or the Maldives. Culturally and socially appropriate strategies must be developed to target oral health issues and a “one-size” fits all approach will be ineffective in addressing the needs of South Asian migrants.

scholarly journals Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1334
Author(s):  
Allan Knox ◽  
Nicholas Sculthorpe ◽  
Fergal Grace
Keyword(s):  
Resistance Exercise ◽  
South Asian ◽  
Metabolic Response ◽  
South Asians ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Asian Population ◽  
Metabolic Health ◽  
The South ◽  
South Asian Population

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise.Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise.Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise (p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise (p>0.05, in both groups). CRP increased in the South Asian group (p<0.05) but not the Caucasian group (p>0.05)Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

European multiple sclerosis risk variants in the south Asian population

2016 ◽  
Vol 22 (12) ◽  
pp. 1536-1540 ◽  
Author(s):  
Lekha Pandit ◽  
Maria Ban ◽  
Ashley Harris Beecham ◽  
Jacob L McCauley ◽  
Stephen Sawcer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
South Asian ◽  
Association Studies ◽  
South Asians ◽  
Asian Population ◽  
The South ◽  
Single Nucleotide Variants ◽  
South Asian Population ◽  
Risk Variants ◽  
Increased Risk

Background: In less than a decade, genomewide association studies have identified over 100 single-nucleotide variants that are associated with increased risk of developing multiple sclerosis. However, since these studies have focused almost exclusively on European populations, it is unclear what role these variants might play in determining risk in other ethnic groups. Objective: To assess the effects of European multiple sclerosis–associated risk variants in the south Asian population. Methods: Using a combination of chip-based genotyping and next-generation sequencing, we have assessed 109 European-associated variants in a total of 270 cases and 555 controls from the south Asian population. Results: We found that two-thirds of the tested variants (72/109) showed over representation of the European risk allele in south Asian cases ( p < 0.0003). In the rest of the Immunochip array, the most associated variant was rs7318477 which maps close to TNFSF13B, the gene for the B-cell-related protein BAFF. Conclusion: Our data indicate substantial overlap in genetic risk architecture between Europeans and south Asians and suggest that the aetiology of the disease may be largely independent of ethnicity.

255Impact of the type of acute coronary syndrome on the pharmocodynamic response to P2Y12 inhibitors in the acute and maintenance phase of therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Lugo Gavidia ◽  
D Vivas ◽  
J M De La Hera ◽  
A Tello-Montoliu ◽  
A L Marcano ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Maintenance Phase ◽  
Platelet Inhibition ◽  
Clinical Indication ◽  
P2y12 Inhibitor ◽  
P2y12 Inhibitors ◽  
Coronary Syndrome ◽  
P2y12 Antagonists ◽  
St Elevation ◽  
The Impact

Abstract Background The presence of an acute coronary syndrome (ACS) is per se a predictor of reduced responsiveness to clopidogrel; in particular, patients with ST-elevation myocardial infarction (STEMI) have impaired clopidogrel-induced platelet inhibition than those with other forms of ACS. However, the impact of the type of ACS on the pharmocodynamic efficacy of more potent P2Y12 antagonists such as prasugrel or ticagrelor has not been fully elucidated to date. Purpose To assess the impact of the type of ACS on platelet inhibition mediated by P2Y12 receptor antagonists in the acute and the maintenance phase of therapy in a contemporary cohort of ACS patients undergoing percutaneous coronary intervention (PCI). Methods Substudy of a prospective, national, multicentre, pharmacodynamic registry conducted in a population of ACS patients undergoing PCI and treated with dual antiplatelet therapy including aspirin and a P2Y12 inhibitor as per clinical indication. Patients were classified according to the ACS diagnosis into groups: a) STEMI, b) non-ST-elevation ACS (NSTEACS), c) unstable angina (UA), and d) other (excluded from the present analysis). Platelet function tests (PFT) were performed at day 1 and day 30 (±5) after PCI and included: 1) VerifyNow P2Y12 assay, expressed as P2Y12 reaction units (PRUs); 2) Vasodilator-stimulated phosphoprotein (VASP) assay; and 3) Multiple electrode aggregometry (MEA). Results A total of 965 patients (372 with STEMI, 395 with NSTEACS and 198 with UA) were included in the present substudy. At day 1, the proportions of patients with each type of ACS according to the P2Y12 inhibitor received were: 1) clopidogrel (n=317): STEMI 35.0%, NSTEACS 34.4% and UA 30.6%; 2) prasugrel (n=192): STEMI 70.3%, NSTEACS 17.7% and UA 12.0%; 3) ticagrelor (n=456): STEMI 27.6%, NSTEACS 55.3% and UA 17.1%. A statistically significant reduced platelet inhibition, measured with the VerifyNow system, was observed in STEMI patients compared with the other forms of ACS in patients receiving clopidogrel (STEMI: 217.3±8.1, NSTEACS: 157.1±7.9 and UA: 164.9±8.6 PRUs; p for STEMI vs. NSTEACS <0.001 and p for STEMI vs. UA <0.001) and ticagrelor (STEMI: 57.7±3.8, NSTEACS: 45.2.1±2.6 and UA: 40.6±4.9 PRUs; p for STEMI vs. NSTEACS 0.008 and p for STEMI vs. UA 0.007), while a numerical trend towards greater platelet reactivity in STEMI compared to UA was observed in subjects receiving prasugrel (Figure). Remarkably, at day 30, no significant differences on platelet inhibition were observed according to the ACS type with any of the P2Y12 inhibitors. Similar results were observed with MEA and VASP assays. PD response according to the ACS type Conclusions Patients presenting with STEMI have impaired platelet inhibition mediated by P2Y12 antagonists compared to other types of ACS during the acute phase of therapy, whereas no difference is observed during the maintenance phase of treatment. Acknowledgement/Funding Funded by Instituto de Salud Carlos III through the project PI13/01012 (co-funded by European Regional Development Fund. ERDF, a way to build Europe)

scholarly journals Stress Hyperglycaemia During Acute Coronary Syndrome of Non-Diabetic Patients

2018 ◽  
Vol 25 ◽  
pp. 30-34
Author(s):  
Z Rahman ◽  
ASMM Rahman ◽  
ARMS Ekram ◽  
R Uddin ◽  
MK Rahman ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Asian Population ◽  
Diabetic Patients ◽  
South Asian Population ◽  
College Hospital ◽  
Cross Sectional ◽  
Acute Hyperglycemia ◽  
Coronary Syndrome ◽  
Study Population ◽  
Glucose Abnormalities

The risk of diabetes mellitus and coronary heart disease is high among South-Asian population. In this study, our objective was to measure blood glucose level during acute coronary syndrome of previously known non-diabetic patients that will give the information about the frequency of acute hyperglycemia in acute coronary syndrome (ACS) among Bangladeshi population. It is an observational cross sectional study performed in Rajshahi Medical College Hospital. A total of 248 non-diabetic subjects with ACS got admitted into hospital. FBS and standard OGTT within 3 days of ACS were done. This study was done to find out glucose abnormalities among ACS patients. Out of 248 study population, 135(54.44%) had glucose abnormalities. Male was 87.10% (216). Among male, IGT (prediabetic) was 31.94% (69) and diabetic 24.54% (53). Mean age (±SD) of our study population was 51.71±11.84 years. Normal glucose tolerance (NGT) was found in 45.6% (113) cases, IGT (prediabetic) and diabetic were detected among 30.6% (76) and 23.8% (59) cases respectively. Non-diabetic Bangladeshi patients showed a high prevalence of hyperglycemia in acute coronary syndrome (ACS). We should create awareness about a new risk factor- acute hyperglycemia during acute coronary syndrome and take appropriate and effective measures to reduce morbidity as well as mortality as a consequence of acute hyperglycemia during ACS with or without diabetes.TAJ 2012; 25: 30-34

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