Ethnic Differences in Coronary Revascularisation following an Acute Coronary Syndrome in New Zealand: A National Data-linkage Study (ANZACS-QI 12)

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• 作者：Corina Grey ; MBChB ; MPH ; FNZCPHM^a ; ^{c.grey@auckland.ac.nz" class="auth_mail" title="E-mail the corresponding author} ; Rod Jackson ; MBChB ; PhD ; FNZCPHM^a ; Susan Wells ; MBChB ; PhD ; FNZCPHM^a ; Deborah Randall ; BSc ; MBiostat^b ; Matire Harwood ; MBChB ; PhD^a ; Suneela Mehta ; MBChB ; MPH ; FNZCPHM^a ; Daniel J. Exeter ; BA ; MA ; PhD^a ; Andrew J. Kerr ; MBChB ; FRACP^a ; ^c
• 关键词：Acute coronary syndromes ; Myocardial infarction ; Coronary revascularisation
• 刊名：Heart, Lung and Circulation
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：25
• 期：8
• 页码：820-828
• 全文大小：248 K

文摘

The aim of this study was to describe ethnic differences in angiography and revascularisation rates following an acute coronary syndrome (ACS) in New Zealand.

Methods

National hospitalisation and mortality data were anonymously linked to determine receipt of angiography and revascularisation for 30-84 year-olds hospitalised with ACS between 2007 and 2012. Multilevel Cox regression, accounting for individual factors and admitting hospital, was used to estimate adjusted procedural rates within 30 days of admission.

Results

Of the 50,324 ACS patients included, 10% were Māori, 4% Pacific, 3% Indian and 83% New Zealand European or Other ethnicities (NZEO). A larger proportion of Māori (48%) than NZEO (36%), Pacific (19%) and Indian (14%) patients were admitted to hospitals without catheterisation facilities. More Māori and Pacific (22-24%) than NZEO and Indian patients (12-13%) had severe comorbidities. Māori and Pacific were less likely than NZEO patients to receive angiography (adjusted HRs 0.94 [0.91-0.98] and 0.93 [0.87-0.98] respectively) and revascularisation (adjusted HRs 0.79 [0.75-0.83] and 0.77 [0.71-0.83]), even after adjusting for important demographic and clinical factors.

Conclusions

A higher comorbidity burden in Māori and Pacific patients and reduced access to catheterisation facilities for non-urban Māori contributed to lower procedure rates after ACS admission. Ethnic differences remained after adjustment for these factors and require further investigation.