--- title: "Treatment and outcomes among Asians with CAD in U.S. | Sutter Health" description: "Disaggregation of Asian Americans with CAD into individual racial/ethnic subgroups reveals significant variability in treatment patterns and outcomes." url: "https://www.sutterhealth.org/research/publications/treatment-and-outcomes-among-asians-with-cad-in-us-1055312760" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Treatment and outcomes among Asians with CAD in U.S. # Heterogeneity of treatment and outcomes among Asians with coronary artery disease in the United States. Manjunath L, Chung S, Li J, Shah H, Palaniappan L, & Yong CM. _J Am Heart Assoc. e014362. doi: 10.1161/JAHA.119.014362. \[Epub ahead of print\]_ 2020-05-11 ## Abstract Background: Prior data demonstrate significant heterogeneity regarding coronary artery disease risk factors and outcomes among Asians in the United States, but no studies have yet examined coronary artery disease treatment patterns or outcomes among disaggregated Asian American subgroups. Methods and Results: From a total of 772 882 patients with known race/ethnicity and sex who received care from a mixed-payer healthcare organization in Northern California between 2006 and 2015, a retrospective analysis was conducted on 6667 adults with coronary artery disease. Logistic regression was used to examine medical and procedural therapies and outcomes by race/ethnicity, with adjustment for age, sex, income, and baseline comorbidities. Compared with non-Hispanic whites, Chinese were more likely to undergo stenting (50.9% versus 60.8%, odds ratio \[OR\] 1.39 \[95% CI, 1.04-1.87\], p=0.005), whereas Filipinos were more likely to receive bypass surgery (6.9% versus 20.5%, OR 2.65 \[95% CI, 1.75-4.01\], P<0.0001). After stenting, Chinese, Filipinos, and Japanese were more likely than non-Hispanic whites to be prescribed clopidogrel (86.2%, 83.0%, and 91.4% versus 74.5%, ORs 1.86 \[95% CI, 1.13-3.04\], 1.86 \[95% CI, 1.01-3.44\], and 4.37 \[95% CI, 1.02-18.67\], respectively, P<0.0001). Lastly, Chinese and Asian Indians were more likely than non-Hispanic whites to be diagnosed with a myocardial infarction within 1 year postangiography (15.6% and 17.4% versus 11.2%, ORs 1.49 \[95% CI, 1.02-2.19\] and 1.68 \[95% CI, 1.21-2.34\], respectively, P<0.0001). Conclusions: Disaggregation of Asian Americans with coronary artery disease into individual racial/ethnic subgroups reveals significant variability in treatment patterns and outcomes. Further investigation into these differences may expose important opportunities to mitigate disparities and improve quality of care in this diverse population. [PubMed abstract](https://pubmed.ncbi.nlm.nih.gov/32390539/) ![Jiang Li, Ph.D., MPH](https://dyn.mktgcdn.com/p/H4OFJqNxBzDqkSWaIqDBiZgqIsHNsHLWdLuMd9IlNx0/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Jiang Li, Ph.D., MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Atherosclerotic cardiovascular disease risk prediction in disaggregated Asian and Hispanic subgroups using electronic health records.](https://www.sutterhealth.org/research/publications/cvd-risk-prediction-in-asian-and-hispanic-subgroups-in-ehrs-1055312765) Rodriguez F, Chung S, Blum MR, Coulet A, Basu S, Palaniappan LP. J Am Heart Assoc. 8(14):e011874. doi: 10.1161/JAHA.118.011874. Epub 2019 Jul 11. 2019 Jul 16 - Publication ### [Profiles of sociodemographic, behavioral, clinical and psychosocial characteristics among primary care patients with comorbid obesity and depression.](https://www.sutterhealth.org/research/publications/characteristics-primary-care-pts-with-obesity-depression-1055312347) Ma J, Xiao L, Lv N, Rosas LG, Lewis MA, Goldhaber-Fiebert JD, Venditti EM, Snowden MB, Lesser L, Ward E. Prev Med Rep. 8:42-50. doi: 10.1016/j.pmedr.2017.07.010. eCollection 2017 Dec. 2017 Aug 05 - Publication ### [Under diagnosis of hypertension using electronic health records.](https://www.sutterhealth.org/research/publications/under-diagnosis-of-hypertension-using-ehr-1055312667) Banerjee D, Chung S, Wong EC, Wang EJ, Stafford RS, Palaniappan LP. Am J Manag Care. 16(2):e35-42 2010 Feb 01 - Publication ### [Machine learning and atherosclerotic cardiovascular disease risk prediction in a multi-ethnic population.](https://www.sutterhealth.org/research/publications/asvd-risk-prediction-in-multi-ethnic-population-1055312841) Ward A, Sarraju A, Chung S, Li J, Harrington R, Heidenreich P, Palaniappan L, Scheinker D, Rodriguez F. NPJ Digit Med. 3:125. doi: 10.1038/s41746-020-00331-1. eCollection 2020. 2020 Sep 23 - Publication ### [Racial/ethnic differences in dyslipidemia patterns.](https://www.sutterhealth.org/research/publications/racial-ethnic-differences-in-dyslipidemia-patterns-1055312616) Frank AT, Zhao B, Jose PO, Azar KM, Fortmann SP, Palaniappan LP. Circulation. 129(5):570-9. doi: 10.1161/CIRCULATIONAHA.113.005757. Epub 2013 Nov 5. 2014 Feb 04 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/treatment-and-outcomes-among-asians-with-cad-in-us-1055312760#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Treatment and outcomes among Asians with CAD in U.S."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/treatment-and-outcomes-among-asians-with-cad-in-us-1055312760#medicalscholarlyarticle","name":"Heterogeneity of treatment and outcomes among Asians with coronary artery disease in the United States.","headline":"Treatment and outcomes among Asians with CAD in U.S.","abstract":"Background: Prior data demonstrate significant heterogeneity regarding coronary artery disease risk factors and outcomes among Asians in the United States, but no studies have yet examined coronary artery disease treatment patterns or outcomes among disaggregated Asian American subgroups. Methods and Results: From a total of 772 882 patients with known race/ethnicity and sex who received care from a mixed-payer healthcare organization in Northern California between 2006 and 2015, a retrospective analysis was conducted on 6667 adults with coronary artery disease. Logistic regression was used to examine medical and procedural therapies and outcomes by race/ethnicity, with adjustment for age, sex, income, and baseline comorbidities. Compared with non-Hispanic whites, Chinese were more likely to undergo stenting (50.9% versus 60.8%, odds ratio [OR] 1.39 [95% CI, 1.04-1.87], p=0.005), whereas Filipinos were more likely to receive bypass surgery (6.9% versus 20.5%, OR 2.65 [95% CI, 1.75-4.01], P\u003c0.0001). After stenting, Chinese, Filipinos, and Japanese were more likely than non-Hispanic whites to be prescribed clopidogrel (86.2%, 83.0%, and 91.4% versus 74.5%, ORs 1.86 [95% CI, 1.13-3.04], 1.86 [95% CI, 1.01-3.44], and 4.37 [95% CI, 1.02-18.67], respectively, P\u003c0.0001). Lastly, Chinese and Asian Indians were more likely than non-Hispanic whites to be diagnosed with a myocardial infarction within 1 year postangiography (15.6% and 17.4% versus 11.2%, ORs 1.49 [95% CI, 1.02-2.19] and 1.68 [95% CI, 1.21-2.34], respectively, P\u003c0.0001). Conclusions: Disaggregation of Asian Americans with coronary artery disease into individual racial/ethnic subgroups reveals significant variability in treatment patterns and outcomes. Further investigation into these differences may expose important opportunities to mitigate disparities and improve quality of care in this diverse population.","description":"Disaggregation of Asian Americans with CAD into individual racial/ethnic subgroups reveals significant variability in treatment patterns and outcomes.","keywords":["Cardiovascular Diseases","Health Disparities","Medical Informatics"],"datePublished":"2020-05-11","url":"https://www.sutterhealth.org/research/publications/treatment-and-outcomes-among-asians-with-cad-in-us-1055312760","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"32390539"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1161/JAHA.119.014362"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/32390539/","https://doi.org/10.1161/JAHA.119.014362"],"isPartOf":{"@type":"Periodical","name":"J Am Heart Assoc"},"author":[{"@type":"Person","name":"Manjunath L"},{"@type":"Person","name":"Chung S"},{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008","name":"Li J","url":"https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008"},{"@type":"Person","name":"Shah H"},{"@type":"Person","name":"Palaniappan L"},{"@type":"Person","name":"Yong CM"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Cardiovascular Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cardiovascular+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Medical Informatics","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Medical+Informatics%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/treatment-and-outcomes-among-asians-with-cad-in-us-1055312760","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/treatment-and-outcomes-among-asians-with-cad-in-us-1055312760#breadcrumblist"}}} ```