1. Ethnic Differences in Coronary Revascularisation following an Acute Coronary Syndrome in New Zealand: A National Data-linkage Study (ANZACS-QI 12).
- Author
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Grey, Corina, Jackson, Rod, Wells, Susan, Randall, Deborah, Harwood, Matire, Mehta, Suneela, Exeter, Daniel J., and Kerr, Andrew J.
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CORONARY arteries , *REVASCULARIZATION (Surgery) , *ACUTE coronary syndrome , *DEATH rate , *ANGIOGRAPHY , *CARDIOVASCULAR system , *CLINICAL trials , *COMPARATIVE studies , *DATABASES , *RESEARCH methodology , *MEDICAL care , *MEDICAL cooperation , *MYOCARDIAL infarction , *RESEARCH , *EVALUATION research ,MYOCARDIAL infarction-related mortality - Abstract
Background: 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. [ABSTRACT FROM AUTHOR]- Published
- 2016
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