-
Tytuł:
-
Cardiac procedures in ST-segment-elevation myocardial infarction - the influence of age, geography and Aboriginality.
-
Autorzy:
-
Taylor LK; Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia.
Nelson MA; Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia. .
Gale M; Office of the Chief Health Officer, NSW Ministry of Health, Sydney, Australia.
Trevena J; Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia.
Brieger DB; Concord Repatriation General Hospital, Sydney, Australia.
Winch S; Illawarra Local Aboriginal Lands Council, Wollongong, Australia.
Cretikos MA; Centre for Population Health, NSW Ministry of Health, Sydney, Australia.
Newman LA; Epidemiology Section, Population Health Protection and Prevention, ACT Health, Canberra, Australia.
Phung HN; Epidemiology Section, Population Health Protection and Prevention, ACT Health, Canberra, Australia.
Faddy SC; Clinical Services, NSW Ambulance, Sydney, Australia.
Kelly PM; ACT Chief Health Officer & Deputy Director-General, Population Health Protection and Prevention, ACT Health, Canberra, Australia.
Chant K; Chief Health Officer, NSW Ministry of Health, Sydney, Australia.
-
Źródło:
-
BMC cardiovascular disorders [BMC Cardiovasc Disord] 2020 May 14; Vol. 20 (1), pp. 224. Date of Electronic Publication: 2020 May 14.
-
Typ publikacji:
-
Journal Article; Observational Study; Research Support, Non-U.S. Gov't
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: London : BioMed Central, [2001-
-
MeSH Terms:
-
Coronary Artery Bypass*/trends
Native Hawaiian or Other Pacific Islander*
Percutaneous Coronary Intervention*/trends
Healthcare Disparities/*ethnology
ST Elevation Myocardial Infarction/*therapy
Adult ; Age Factors ; Aged ; Australian Capital Territory ; Coronary Angiography/trends ; Databases, Factual ; Female ; Healthcare Disparities/trends ; Humans ; Male ; Middle Aged ; New South Wales/epidemiology ; Race Factors ; Residence Characteristics ; Risk Factors ; ST Elevation Myocardial Infarction/diagnostic imaging ; ST Elevation Myocardial Infarction/ethnology ; ST Elevation Myocardial Infarction/mortality ; Time-to-Treatment/trends ; Treatment Outcome
-
References:
-
Med J Aust. 2016 Aug 1;205(3):114-20. (PMID: 27465766)
BMC Public Health. 2009 Dec 14;9:460. (PMID: 20003401)
Med J Aust. 2016 Aug 1;205(3):128-33. (PMID: 27465769)
J Am Coll Cardiol. 2011 May 10;57(19):1920-59. (PMID: 21450428)
Med J Aust. 2014 Aug 4;201(3):158-61. (PMID: 25128951)
Med J Aust. 2013 Aug 5;199(3):185-91. (PMID: 23909541)
Heart Lung Circ. 2016 Sep;25(9):895-951. (PMID: 27476580)
Circulation. 2013 Feb 19;127(7):811-9. (PMID: 23319820)
Eur Heart J. 2012 Oct;33(20):2569-619. (PMID: 22922416)
Eur Heart J. 2016 Jan 14;37(3):267-315. (PMID: 26320110)
Med J Aust. 2016 Aug 1;205(3):121-5. (PMID: 27465767)
-
Contributed Indexing:
-
Keywords: Angiography; Percutaneous coronary intervention; ST-segment elevation myocardial infarction (STEMI)
-
Entry Date(s):
-
Date Created: 20200516 Date Completed: 20201124 Latest Revision: 20211204
-
Update Code:
-
20240105
-
PubMed Central ID:
-
PMC7227061
-
DOI:
-
10.1186/s12872-020-01487-0
-
PMID:
-
32408860
-
Background: Timely restoration of bloodflow acute ST-segment elevation myocardial infarction (STEMI) reduces myocardial damage and improves prognosis. The objective of this study was describe the association of demographic factors with hospitalisation rates for STEMI and time to angiography, Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG) in New South Wales (NSW) and the Australian Capital Territory (ACT), Australia.
Methods: This was an observational cohort study using linked population health data. We used linked records of NSW and the ACT hospitalisations and the Australian Government Medicare Benefits Schedule (MBS) for persons aged 35 and over hospitalised with STEMI in the period 1 July 2010 to 30 June 2014. Survival analysis was used to determine the time between STEMI admission and angiography, PCI and CABG, with a competing risk of death without cardiac procedure.
Results: Of 13,117 STEMI hospitalisations, 71% were among males; 55% were 65-plus years; 64% lived in major cities, and 2.6% were Aboriginal people. STEMI hospitalisation occurred at a younger age in males than females. Angiography and PCI rates decreased with age: angiography 69% vs 42% and PCI 60% vs 34% on day 0 for ages 35-44 and 75-plus respectively. Lower angiography and PCI rates and higher CABG rates were observed outside major cities. Aboriginal people with STEMI were younger and more likely to live outside a major city. Angiography, PCI and CABG rates were similar for Aboriginal and non-Aboriginal people of the same age and remoteness area.
Conclusions: There is a need to improve access to definitive revascularisation for STEMI among appropriately selected older patients and in regional areas. Aboriginal people with STEMI, as a population, are disproportionately affected by access to definitive revascularisation outside major cities. Improving access to timely definitive revascularisation in regional areas may assist in closing the gap in cardiovascular outcomes between Aboriginal and non-Aboriginal people.
