Grant: Operating Grant

Acute coronary syndrome (ACS) (heart attack or unstable angina)is one of the leading causes of death in North America. Prognosis from ACS appears to vary by ethnicity with higher early mortality in Chinese patients and higher risk of recurrent heart attack in South Asian and White patients compared to Chinese patients. As we know that proper ACS management and health behavior change like taking cardiac medications and quitting smoking significantly improves prognosis, one possible explanation for ethnic differences in prognosis is variations in ACS management and adoption of heart healthy behaviors. The goals of this study are to (1) systematically compare ACS management and health behavior change in South Asian, Chinese and White patients with ACS and (2) to examine potential patient level - cultural factors that may influence cardiac care and health behavior change such as language barriers, poor knowledge of cardiac risk factors, and use of traditional therapies. To achieve this goal, we will follow 1827 patients with recent ACS (609 from each ethnic group) in Vancouver, Calgary and Toronto who have already been enrolled in one of our other studies called ACS cross sectional study. Patients who agree to join this study will receive telephone interviews at 3,6 and 12 months after ACS to collect the data. We will carefully translate all of the study documents so that South Asian and Chinese patients who do not speak english can also take place in this study. This study will help us learn where the care gaps in ACS management occur in these ethnic groups and also help us learn how culture affects chronic disease management and cardiac care. These findings will be instrumental in developing targeted interventions aimed at improving ACS management in a culturally sensitive manner.