Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity
Background: We investigated the relationship between Aboriginality and 2-year cardiovascular disease outcomes in non-fatal first-ever myocardial infarction during 2000–04, with progressive adjustment of covariates, including comorbidities. Design: Historical cohort study. Methods: Person-linked hosp...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
Sage Publications Ltd.
2011
|
| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/11855 |
| _version_ | 1848747916813926400 |
|---|---|
| author | Katzenellenbogen, Judith M. Sanfilippo, F. Hobbs, M. Briffa, T. Ridout, S. Knuiman, M. Dimer, L. Taylor, Kate Thompson, P. Thompson, S. |
| author_facet | Katzenellenbogen, Judith M. Sanfilippo, F. Hobbs, M. Briffa, T. Ridout, S. Knuiman, M. Dimer, L. Taylor, Kate Thompson, P. Thompson, S. |
| author_sort | Katzenellenbogen, Judith M. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: We investigated the relationship between Aboriginality and 2-year cardiovascular disease outcomes in non-fatal first-ever myocardial infarction during 2000–04, with progressive adjustment of covariates, including comorbidities. Design: Historical cohort study. Methods: Person-linked hospital and mortality records were used to identify 28-day survivors of first-ever myocardial infarction in Western Australia during 2000–04 with 15-year lookback. The outcome measures were: (1) cardiovascular disease death; (2) recurrent admission for myocardial infarction; and (3) the composite of (1) and (2). Results: Compared with non-Aboriginal patients, Aboriginals were younger and more likely to live remotely. The proportions having 5-year histories of diabetes and chronic kidney disease were double and triple those of non-Aboriginals. When adjusting for demographic variables alone, the Aboriginal to non-Aboriginal hazard ratios for cardiovascular death or recurrent myocardial infarction were 3.6 (95% CI 2.5–5.3) in men and 4.5 (95% CI 2.8–7.3) in women. After adjustment for comorbidities, including diabetes, chronic kidney disease and heart failure, the hazard ratios decreased 36% and 47% to 2.3 (1.6–3.0) and 2.4 (1.5–4.0) in males and females, respectively. Conclusions: The high prevalence of comorbidities in Aboriginal people, including diabetes, kidney disease, heart failure, and other risk factors contribute substantially to the disparity in post-myocardial infarction outcomes in Aboriginal people, reinforcing the importance of both primary prevention and comprehensive management of chronic conditions in this population. Aboriginality remains a significant independent risk factor for disease recurrence or mortality, even after adjusting for comorbidity, suggesting the need for society-level interventions addressing social disadvantage. |
| first_indexed | 2025-11-14T06:56:45Z |
| format | Journal Article |
| id | curtin-20.500.11937-11855 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:56:45Z |
| publishDate | 2011 |
| publisher | Sage Publications Ltd. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-118552017-09-13T16:08:58Z Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity Katzenellenbogen, Judith M. Sanfilippo, F. Hobbs, M. Briffa, T. Ridout, S. Knuiman, M. Dimer, L. Taylor, Kate Thompson, P. Thompson, S. myocardial infarction social differentials cardiovascular outcomes Aboriginal Background: We investigated the relationship between Aboriginality and 2-year cardiovascular disease outcomes in non-fatal first-ever myocardial infarction during 2000–04, with progressive adjustment of covariates, including comorbidities. Design: Historical cohort study. Methods: Person-linked hospital and mortality records were used to identify 28-day survivors of first-ever myocardial infarction in Western Australia during 2000–04 with 15-year lookback. The outcome measures were: (1) cardiovascular disease death; (2) recurrent admission for myocardial infarction; and (3) the composite of (1) and (2). Results: Compared with non-Aboriginal patients, Aboriginals were younger and more likely to live remotely. The proportions having 5-year histories of diabetes and chronic kidney disease were double and triple those of non-Aboriginals. When adjusting for demographic variables alone, the Aboriginal to non-Aboriginal hazard ratios for cardiovascular death or recurrent myocardial infarction were 3.6 (95% CI 2.5–5.3) in men and 4.5 (95% CI 2.8–7.3) in women. After adjustment for comorbidities, including diabetes, chronic kidney disease and heart failure, the hazard ratios decreased 36% and 47% to 2.3 (1.6–3.0) and 2.4 (1.5–4.0) in males and females, respectively. Conclusions: The high prevalence of comorbidities in Aboriginal people, including diabetes, kidney disease, heart failure, and other risk factors contribute substantially to the disparity in post-myocardial infarction outcomes in Aboriginal people, reinforcing the importance of both primary prevention and comprehensive management of chronic conditions in this population. Aboriginality remains a significant independent risk factor for disease recurrence or mortality, even after adjusting for comorbidity, suggesting the need for society-level interventions addressing social disadvantage. 2011 Journal Article http://hdl.handle.net/20.500.11937/11855 10.1177/1741826711417925 Sage Publications Ltd. restricted |
| spellingShingle | myocardial infarction social differentials cardiovascular outcomes Aboriginal Katzenellenbogen, Judith M. Sanfilippo, F. Hobbs, M. Briffa, T. Ridout, S. Knuiman, M. Dimer, L. Taylor, Kate Thompson, P. Thompson, S. Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity |
| title | Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity |
| title_full | Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity |
| title_fullStr | Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity |
| title_full_unstemmed | Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity |
| title_short | Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity |
| title_sort | aboriginal to non-aboriginal differentials in 2-year outcomes following non-fatal first-ever acute mi persist after adjustment for comorbidity |
| topic | myocardial infarction social differentials cardiovascular outcomes Aboriginal |
| url | http://hdl.handle.net/20.500.11937/11855 |