Abstract
Background
The differences of the clinical characteristics, risk factors, treatment and prognosis in coronary heart disease (CHD) patients from different races, area and countries are rarely reported.
Methods
Collecting, comparing and analyzing the clinical data and blood examination results of 650 Chinese Han and 640 German Caucasian patients with CHD.
Results
The ratio of the first hospitalization because of CHD in Chinese patients was higher than that in Germans (95.1 vs. 38.1% P < 0.01). CHD occurred most frequently in elder men of both nations. The German CHD patients combined with hypertension, dyslipidemia and abnormal glucose metabolism were clearly more often than Chinese patients. Other risk factors such as fibrinogen, homocysteine and the proportion of positive family history of premature CHD, obesity, hyperuricemia were higher in German patients than that in Chinese patients. However, the ratio of smoking, acute myocardial infarction and the levels of high-sensitivity C-reactive protein in Chinese patients were obviously higher than that in Germans (P < 0.01, P < 0.05). The use of aspirin in both groups was the same, but the use of statins, beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers were distinctly lower in Chinese patients compared to Germans (P < 0.01, P < 0.05). The proportion of percutaneous coronary intervention and coronary artery bypass grafting in Chinese patients was lower than that in Germans (P < 0.01). The usage of drug-eluting stents to bare-metal stents was slightly higher in German patients, whereas it was obviously higher in Chinese patients (P < 0.01).
Conclusion
There were significant differences in clinical characteristics, risk factors and treatment of Chinese Han and German Caucasian patients with CHD.
Similar content being viewed by others
References
Bonnet J, McPherson R, Tedgui A, Simoneau D, Nozza A, Martineau P, Davignon J (2008) CAP investigators comparative effects of 10-mg versus 80-mg Atorvastatin on high-sensitivity C-reactive protein in patients with stable coronary artery disease: results of the CAP (Comparative Atorvastatin Pleiotropic effects) study. Clin Ther 30:2298–2313
Drechsler K, Fikenzer S, Sechtem U, Blank E, Breithardt G, Zeymer U, Niebauer J (2008) The Euro Heart Survey—Germany: diabetes mellitus remains unrecognized in patients with coronary artery disease. Clin Res Cardiol 97:364–370
Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, Whelton PK, He J, InterASIA Collaborative Group (2005) Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 365(9468):1398–1405
Han Q, Chen L, Evans T, Horton R (2008) China and global health. Lancet 372(9648):1439–1441
Hof D, von Eckardstein A (2009) Risk factors in atherosclerotic coronary heart disease. Ther Umsch 66:253–259 (German)
Hu DY, Pan CY, Yu JM, China Heart Survey Group (2006) The relationship between coronary artery disease and abnormal glucose regulation in China: the China Heart survey. Eur Heart J 27:2573–2579
Ivandic BT, Spanuth E, Haase D, Lestin HG, Katus HA (2007) Increased plasma concentrations of soluble CD40 ligand in acute coronary syndrome depend on in vitro platelet activation. Clin Chem 53:1231–1234
Jurado J, Ybarra J, Solanas P, Caula J, Gich I, Pou JM, Romeo JH (2009) Prevalence of cardiovascular disease and risk factors in a type 2 diabetic population of the North Catalonia diabetes study. J Am Acad Nurse Pract 21:140–148
Koenig W, Khuseyinova N, Baumert J, Meisinger C (2008) Prospective study of high-sensitivity C-reactive protein as a determinant of mortality: results from the MONICA/KORA Augsburg Cohort Study, 1984–1998. Clin Chem 54:335–342
Kotseva K, Wood D, Backer GD, Bacquer DD, Pyörälä K, Keil U (2009) on behalf of the EUROASPIRE Study Group EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 16:121–137
Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U (2009) EUROASPIRE Study Group Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 373:929–940
Li G, Zhang P, Wang J, Gregg EW, Yang W, Gong Q, Li H, Li H, Jiang Y, An Y, Shuai Y, Zhang B, Zhang J, Thompson TJ, Gerzoff RB, Roglic G, Hu Y, Bennett PH (2008) The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet 371(9626):1783–1789
Liu Y, Rao K, Wu J, Gakidou E (2008) China’s health system performance. Lancet 372(9653):1914–1923
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Struijker Boudier HA, Zanchetti A (2007) The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) 2007 Guidelines for the management of arterial hypertension. Eur Heart J 28(12):1462-1536
Mirmiran P, Noori N, Zavareh MB, Azizi F (2009) Fruit and vegetable consumption and risk factors for cardiovascular disease. Metabolism 58:460–468
National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) (2002) Third report of the national cholesterol education program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 106:3143-3421
Otsuka T, Kawada T, Katsumata M, Ibuki C, Kusama Y (2008) High-sensitivity C-reactive protein is associated with the risk of coronary heart disease as estimated by the Framingham Risk Score in middle-aged Japanese men. Int J Cardiol 129:245–250
Prugger C, Wellmann J, Heidrich J, Brand-Herrmann SM, Keil U (2008) Cardiovascular risk factors and mortality in patients with coronary heart disease. Eur J Epidemiol 23:731–737
Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, JUPITER Study Group (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359:2195–2207
Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, JUPITER Study Group (2008) Low-risk older patients (50 years and older) with raised highsensitivity CRP (hs-CRP) benefit from rosuvastatin therapy: the JUPITER study. Cardiovasc J Afr 19:332–335
Ridker PM, Silvertown JD (2008) Inflammation, C-reactive protein, and atherothrombosis. J Periodontol 79(Suppl 8):1544–1551
Silber S, Borggrefe M, Böhm M, Hoffmeister HM, Dietz R, Ertl G, Heusch G (2008) Drug-eluting coronary stents and drug eluting balloon catheters: summary of the position papers of the DGK. Clin Res Cardiol 97(8):548–563 (German)
Task Force for Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of European Society of Cardiology, Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernández-Avilés F, Fox KA, Hasdai D, Ohman EM, Wallentin L, Wijns W (2007) Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J 28(13):1598–1660
Van de Werf F, Ardissino D, Betriu A, Cokkinos DV, Falk E, Fox KA, Julian D, Lengyel M, Neumann FJ, Ruzyllo W, Thygesen C, Underwood SR, Vahanian A, Verheugt FW, Wijns W, Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology (2003) Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 24(1):28–66
Werner C, Baumhäkel M, Teo KK, Schmieder R, Mann J, Unger T, Yusuf S, Böhm M (2008) RAS blockade with ARB and ACE inhibitors: current perspective on rationale and patient selection. Clin Res Cardiol 97(7):418–431
WHO (1997) Obesity preventing and managing. The Global Epidemic-Report of a WHO consultation on obesity. World Health Organization, Geneva
Yang G, Kong L, Zhao W, Wan X, Zhai Y, Chen LC, Koplan JP (2008) Emergence of chronic non-communicable diseases in China. Lancet 372(9650):1697–1705
Ye X, Yu Z, Li H, Franco OH, Liu Y, Lin X (2007) Distributions of C-reactive protein and its association with metabolic syndrome in middle-aged and older Chinese people. J Am Coll Cardiol 49:1798–1805
Acknowledgments
We thank all patients for participation in the study. This project was supported by a grant for scientific research from the Chinese Ministry of Education.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zheng, Y., Ma, W., Zeng, Y. et al. Comparative study of clinical characteristics between Chinese Han and German Caucasian patients with coronary heart disease. Clin Res Cardiol 99, 45–50 (2010). https://doi.org/10.1007/s00392-009-0076-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00392-009-0076-3