Evidence mapPaperPMID 26147693Full record

Trial reportPloS one2015

Ethnicity Modifies Associations between Cardiovascular Risk Factors and Disease Severity in Parallel Dutch and Singapore Coronary Cohorts.

Crystel M Gijsberts, Aruni Seneviratna, Leonardo P de Carvalho, Hester M den Ruijter, Puwalani Vidanapthirana, Vitaly Sorokin, Pieter Stella, Pierfrancesco Agostoni, Folkert W Asselbergs, A Mark Richards and 7 more

Abstract readClinical TrialComparative StudyMulticenter Study
In one paragraph

Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Crystel M GijsbertsLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands; The Netherlands Heart Institute (ICIN), Utrecht, The Netherlands.
Aruni SeneviratnaCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore.
Leonardo P de CarvalhoCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore.
Hester M den RuijterLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Puwalani VidanapthiranaDepartment of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Vitaly SorokinDepartment of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Pieter StellaCardiology Department, University Medical Center Utrecht, Utrecht, The Netherlands.
Pierfrancesco AgostoniCardiology Department, University Medical Center Utrecht, Utrecht, The Netherlands.
Folkert W AsselbergsCardiology Department, University Medical Center Utrecht, Utrecht, The Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands; Institute of Cardiovascular Science, faculty of Population Health Sciences, University College London, London, United Kingdom.
A Mark RichardsCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore; Cardiovascular Research Institute (CVRI), National University Heart Centre (NUHCS), National University Health System, Singapore, Singapore.
Adrian F LowCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore.
Chi-Hang LeeCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore.
Huay Cheem TanCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore.
Imo E HoeferLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Gerard PasterkampLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Dominique P V de KleijnLaboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands; The Netherlands Heart Institute (ICIN), Utrecht, The Netherlands; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Cardiovascular Research Institute (CVRI), National University Heart Centre (NUHCS), National University Health System, Singapore, Singapore.
Mark Y ChanCardiac Department, National University Heart Centre, National University Hospital, Singapore, Singapore; Cardiovascular Research Institute (CVRI), National University Heart Centre (NUHCS), National University Health System, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2020 the largest number of patients with coronary artery disease (CAD) will be found in Asia. Published epidemiological and clinical reports are overwhelmingly derived from western (White) cohorts and data from Asia are scant. We compared CAD severity and all-cause mortality among 4 of the world's most populous ethnicities: Whites, Chinese, Indians and Malays.

methodsThe UNIted CORoNary cohort (UNICORN) simultaneously enrolled parallel populations of consecutive patients undergoing coronary angiography or intervention for suspected CAD in the Netherlands and Singapore. Using multivariable ordinal regression, we investigated the independent association of ethnicity with CAD severity and interactions between risk factors and ethnicity on CAD severity. Also, we compared all-cause mortality among the ethnic groups using multivariable Cox regression analysis.

resultsWe included 1,759 White, 685 Chinese, 201 Indian and 224 Malay patients undergoing coronary angiography. We found distinct inter-ethnic differences in cardiovascular risk factors. Furthermore, the associations of gender and diabetes with severity of CAD were significantly stronger in Chinese than Whites. Chinese (OR 1.3 [1.1-1.7], p = 0.008) and Malay (OR 1.9 [1.4-2.6], p<0.001) ethnicity were independently associated with more severe CAD as compared to White ethnicity. Strikingly, when stratified for diabetes status, we found a significant association of all three Asian ethnic groups as compared to White ethnicity with more severe CAD among diabetics, but not in non-diabetics. Crude all-cause mortality did not differ, but when adjusted for covariates mortality was higher in Malays than the other ethnic groups.

conclusionIn this population of individuals undergoing coronary angiography, ethnicity is independently associated with the severity of CAD and modifies the strength of association between certain risk factors and CAD severity. Furthermore, mortality differs among ethnic groups. Our data provide insight in inter-ethnic differences in CAD risk factors, CAD severity and mortality.

Indexed as

Asian PeopleCoronary AngiographyCoronary Artery DiseaseWhite PeopleAgedFemaleHumansMaleMiddle AgedNetherlandsProspective StudiesSeverity of Illness IndexSingapore

Identifiers

PMID26147693
PMCPMC4492665

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.