Abstract：
BACKGROUND: Cardiovascular disease is the leading cause of death worldwide, with significantly worse mortality-related outcomes in ethnic minorities in developed countries. A systematic literature review and meta-analysis of observational studies was conducted to investigate cardiovascular disease-related mortality inequalities between South Asian and White Caucasian ethnic groups.
METHODS: Published studies on mortality between South Asians and Whites in developed countries were retrieved from MEDLINE, PubMed, Embase, Web of Science, and grey literature sources (inception-April 2021) and critically appraised using the Quality in Prognosis Studies tool. Bayesian random-effects meta-analyses were performed for both primary and secondary outcomes. Heterogeneity was determined using the I2 statistic.
RESULTS: Of the 9879 studies screened originally, 41 were deemed eligible. A further 3 studies were included via the later search. Of these, 15 reported cardiovascular disease-related mortality, 23 reported all-cause mortality, and 6 reported both. The meta-analysis results showed that South Asians had a significantly increased risk of cardiovascular disease mortality compared to Whites (risk ratio = 1.32; 95% credible interval = 1.14 to 1.54) and a decreased risk of all-cause mortality (risk ratio = 0.95; 95% credible interval = 0.83 to 1.12).
CONCLUSIONS: South Asians had statistically significantly higher odds of cardiovascular disease-related mortality compared to Whites, but not for all-cause mortality. Risk of bias was a serious concern mainly due to a lack of confounders being reported.
BACKGROUND: PROSPERO: CRD42021240865.
METHODS: Published studies on mortality between South Asians and Whites in developed countries were retrieved from MEDLINE, PubMed, Embase, Web of Science, and grey literature sources (inception-April 2021) and critically appraised using the Quality in Prognosis Studies tool. Bayesian random-effects meta-analyses were performed for both primary and secondary outcomes. Heterogeneity was determined using the I2 statistic.
RESULTS: Of the 9879 studies screened originally, 41 were deemed eligible. A further 3 studies were included via the later search. Of these, 15 reported cardiovascular disease-related mortality, 23 reported all-cause mortality, and 6 reported both. The meta-analysis results showed that South Asians had a significantly increased risk of cardiovascular disease mortality compared to Whites (risk ratio = 1.32; 95% credible interval = 1.14 to 1.54) and a decreased risk of all-cause mortality (risk ratio = 0.95; 95% credible interval = 0.83 to 1.12).
CONCLUSIONS: South Asians had statistically significantly higher odds of cardiovascular disease-related mortality compared to Whites, but not for all-cause mortality. Risk of bias was a serious concern mainly due to a lack of confounders being reported.
BACKGROUND: PROSPERO: CRD42021240865.
摘要：
背景：心血管疾病是全球死亡的主要原因，发达国家少数民族的死亡率相关结果明显更差。对观察性研究进行了系统的文献回顾和荟萃分析，以调查南亚和白人白人之间与心血管疾病相关的死亡率不平等。
方法：已发表的关于发达国家南亚人和白人死亡率的研究从MEDLINE检索，PubMed,Embase,WebofScience,和灰色文献来源（开始至2021年4月），并使用“预后研究质量”工具进行严格评估。对主要和次要结局进行贝叶斯随机效应荟萃分析。使用I2统计量确定异质性。
结果：在最初筛选的9879项研究中，41人被认为是合格的。通过后来的搜索包括了另外3项研究。其中,15例报告的心血管疾病相关死亡率，23人报告了全因死亡率，和6报告两者。荟萃分析结果表明，与白人相比，南亚人心血管疾病死亡率的风险显着增加（风险比=1.32；95％可信区间=1.14至1.54），全因死亡率的风险降低（风险比=0.95；95％可信区间=0.83至1.12）。
结论：与白人相比，南亚人与心血管疾病相关的死亡率在统计学上明显更高，但不是全因死亡率。偏见的风险是一个严重的问题，主要是由于缺乏混杂因素的报道。
背景：PROSPERO：CRD42021240865。
方法：已发表的关于发达国家南亚人和白人死亡率的研究从MEDLINE检索，PubMed,Embase,WebofScience,和灰色文献来源（开始至2021年4月），并使用“预后研究质量”工具进行严格评估。对主要和次要结局进行贝叶斯随机效应荟萃分析。使用I2统计量确定异质性。
结果：在最初筛选的9879项研究中，41人被认为是合格的。通过后来的搜索包括了另外3项研究。其中,15例报告的心血管疾病相关死亡率，23人报告了全因死亡率，和6报告两者。荟萃分析结果表明，与白人相比，南亚人心血管疾病死亡率的风险显着增加（风险比=1.32；95％可信区间=1.14至1.54），全因死亡率的风险降低（风险比=0.95；95％可信区间=0.83至1.12）。
结论：与白人相比，南亚人与心血管疾病相关的死亡率在统计学上明显更高，但不是全因死亡率。偏见的风险是一个严重的问题，主要是由于缺乏混杂因素的报道。
背景：PROSPERO：CRD42021240865。
