{
  "abstract": "Introduction Research in CAD commonly uses broad ethnic categories that group diverse population which can mask clinically important differences. Although earlier CAD onset has been reported in some ethnic groups, it remains unclear whether age at first CAD presentation varies within South Asian and Black populations when disaggregated into granular sub-groups. We hypothesised that, within an English population, age at first CAD presentation differs across South Asian (Bangladeshi, Indian, Pakistani) and Black (African, Caribbean, Other) subgroups.Methods We conducted a retrospective cohort study using the Clinical Practice Research Datalink (CPRD) Aurum primary care database (~30 million patients) linked to Hospital Episode Statistics and mortality from 1stApril 2004–31stMarch 2024. CAD was defined as first MI or revascularisation using validated codes. Ethnicity was ascertained from primary care and hospital records. We compared mean age at CAD onset across ethnic subgroups using multivariable linear regression adjusted for sex, socioeconomic deprivation (IMD), diabetes, hypertension, smoking, dyslipidaemia, BMI, and family history of CAD.Results We identified 597,548 patients with CAD: 88.1% White, 5.4% South Asian, 1.8% Black, and 4.7% other or unknown ( table 1). Mean age at CAD was 68.0 yrs in White, 61.1 yrs in South Asian, and 62.6 yrs in Black patients (figure 1).After full adjustment, South Asian ethnicity was associated with CAD onset 6.15 yrs earlier than White (95% CI, −6.29, −6.00) and Black 5.69 yrs earlier (−5.93, −5.45) (table 2, figure 2). Among South Asians, Bangladeshi experienced CAD 8.75 yrs earlier (−9.12, −8.38), Pakistani 7.39 yrs earlier (−7.63, −7.15), and Indian 4.63 yrs earlier (−4.83, −4.44). Among Black groups, African experienced CAD 9.41 yrs earlier (−9.80, −9.03), Other Black 8.65 yrs earlier (−9.30, −7.99), and Caribbean 1.88 yrs earlier (−2.23, −1.53).Traditional cardiovascular risk factors and deprivation partly explained differences for Bangladeshi (from 11 yrs younger to 9 yrs younger) and Pakistani (from 9 yrs younger to 7 yrs younger) groups but had minimal effect on Indian, African, Caribbean, and Other Black subgroups (figure 2). Despite adjustment, substantial disparities persisted across all minority ethnic groups.Conclusions Disaggregating broad ethnic categories revealed substantial differences in CAD presentation age. Bangladeshi, Black African, and Other Black patients presented almost a decade younger than White patients, whereas Indian presented 5 yrs earlier and Caribbean 2 yrs earlier. Further epidemiological studies are needed to define subgroup-specific incidence and risk drivers. Population-based risk assessment and prevention initiatives could consider offering Bangladeshi and Black African individuals’ formal assessment earlier than baseline populations.Abstract 450 Table 1Demographics for CAD patients (total n = 597,548)Abstract 450 Figure 1Violin plots display age distributions with overlaid boxplots (white boxes: interquartile range; horizontal line: median) and mean values (orange diamonds)Abstract 450 Table 2Multivariable linear regression: association between ethnicity and age at CAD onsetAbstract 450 Figure 2Unadjusted and adjusted differences in mean age at CAD onset by ethnicity",
  "authors": [
    {
      "affiliations": [
        "Institute of Cardiovascular sciences, University College of London, Euston Road, NWDA, LONDON, United Kingdom"
      ],
      "name": "Nalin Natarajan"
    },
    {
      "affiliations": [
        "Institute of Cardiovascular sciences, University College of London, Euston Road, NWDA, LONDON, United Kingdom"
      ],
      "name": "Sadaf Diamondali"
    },
    {
      "affiliations": [
        "Queen Mary University of London, Mile End Rd, Bethnal Green, London E NS, LONDON, United Kingdom"
      ],
      "name": "Krishnaraj Rathod"
    },
    {
      "affiliations": [
        "Queen Mary University of London, Mile End Rd, Bethnal Green, London E NS, LONDON, United Kingdom"
      ],
      "name": "Fizzah Choudry"
    },
    {
      "affiliations": [
        "Institute of Cardiovascular sciences, University College of London, Euston Road, NWDA, LONDON, United Kingdom"
      ],
      "name": "Abhishek Joshi"
    },
    {
      "affiliations": [
        "Institute of Cardiovascular sciences, University College of London, Euston Road, NWDA, LONDON, United Kingdom"
      ],
      "name": "Sophie Eastwood"
    },
    {
      "affiliations": [
        "Institute of Cardiovascular sciences, University College of London, Euston Road, NWDA, LONDON, United Kingdom"
      ],
      "name": "Nishi Chaturvedi"
    },
    {
      "affiliations": [
        "Institute of Cardiovascular sciences, University College of London, Euston Road, NWDA, LONDON, United Kingdom"
      ],
      "name": "Riyaz Patel"
    }
  ],
  "title": "450 Ethnic differences in onset of coronary artery disease (CAD) in England: a 20-year cohort study, 2004–2024",
  "uid": "517de2fa-39d5-5f88-b312-6cbd31129681"
}