Samin Sharma is never going to have to deliver curries again.

“Those were the days,” he said over a lunch of pasta.

He made $3 an hour in those days, when he came to New York to practice cardiac surgery from Jaipur in India’s western state of Rajasthan. He graduated at the top of his class in the national qualifying exam, but no hospital in the city would give him a job until he was certified by New York State. While he prepared for the test, he delivered curries for an Indian fast-food outlet.

That was two decades ago. Now, the 47-year-old Mount Sinai physician performs more angioplasties annually than any other cardiovascular physician in the world – in excess of 1,300 a year, or a third of the procedures done at the “cath lab” that he heads.

He also makes several million dollars a year.

“Heart disease continues to rise in America,” Dr. Sharma said, noting that last year more than 13 million Americans had cardiac problems.

Some 700,000 of them died, making heart disease second only to cancer as a cause of death. More than 1 million angioplasties are performed in America each year, three times the number of bypass operations.

And as America continues to attract immigrants, medical studies, including a seminal one conducted by Dr. Sharma, show that South Asian men in particular are more vulnerable to heart disease. Of more than 5 million immigrants of Asian origin since 1970, 1 million are from South Asia, including India.

“They are getting heart disease at younger and younger ages,” Dr. Sharma said. “Why is this so? It’s the change in lifestyle when they come to America. They don’t check their cholesterol regularly. Many don’t exercise regularly. And many cannot cope with the increased stress of trying to make it in America.”

A large number of his patients are Asians. (Disclosure: This reporter was treated by Dr. Sharma several years ago.) They come to him from all parts of America and from abroad, particularly India.

The angioplasties that are Dr. Sharma’s specialty can easily cost $20,000, though they rarely involve more than an overnight stay at the hospital. Heart bypass surgery can cost more than double that, and usually requires a patient to be hospitalized for a week. Dr. Sharma’s unit last year contributed more than $150 million in revenues to Mount Sinai.

Because angioplasty is getting more and more sophisticated, and the in-hospital death rate is under 1% – compared to 2.4% for bypass surgery – patients are increasingly opting for it. According to the American Heart Association, the number of angioplasties in New York State last year was 50,000, a 20% increase from 2003. But the number of heart bypasses was 17,000 in 2004,down 8,000 from the previous year.

But angioplasty has lately drawn its share of controversy. In an article in the Journal of the American Medical Association, two physicians from Centro Cuore Columbus Hospital in Milan said their research showed that two of the most popular medicated stents, the Cypehr and Taxus brands, had serious side effects, and in some cases caused deaths. Of the 2,229 angioplasty patients in the Italian study, 29 developed blood clots, and 13 died after the procedure.

The increasing use of stents has made it into a $5 billion-a-year industry in America.

Dr. Sharma acknowledged that even though he takes on “very high-risk cases,” angioplasty is often not advisable for patients whose left main artery is severely blocked. The state’s Department of Health said Dr. Sharma has the best record in New York in angioplasty since 1994.

“Overall, angioplasty is safe, causes much less trauma than bypass surgery, and these coated stents block the stimulation of muscle cells, that is, they help prevent blockages from recurring,” he said.

His technique is so effective that physicians from across the country take his seminars on angioplasty, in which he explains his method while a video camera in the operating theater transmits the lesson to dozens of locations.

One of those locations is in his native Jaipur, where Dr. Sharma contributed $1 million to open a heart center late last year. Some 15% of its patients receive free care through Dr. Sharma’s philanthropy. He travels to India four times a year to lecture on angioplasty, and elsewhere in Asia and Europe.