Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting
Background: Indigenous Australians have higher rates of cardiovascular disease and comorbidities compared to their non-indigenous counterparts. Aims: We sought to evaluate whether indigenous status per se portends a worse prognosis following isolated coronary artery bypass grafting (CABG). Methods:...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
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Blackwell Publishing
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/73686 |
| _version_ | 1848763071573524480 |
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| author | O'Brien, J. Saxena, A. Reid, Christopher Tran, L. Baker, R. Newcomb, A. Smith, J. Huq, M. Duffy, S. |
| author_facet | O'Brien, J. Saxena, A. Reid, Christopher Tran, L. Baker, R. Newcomb, A. Smith, J. Huq, M. Duffy, S. |
| author_sort | O'Brien, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Indigenous Australians have higher rates of cardiovascular disease and comorbidities compared to their non-indigenous counterparts. Aims: We sought to evaluate whether indigenous status per se portends a worse prognosis following isolated coronary artery bypass grafting (CABG). Methods: The outcomes of 778 Indigenous Australians (55 ± 10 years; 32% female) enrolled in the Australian and New Zealand Society of Cardiac and Thoracic Surgeons registry were compared to 36 124 non-Indigenous Australians (66 ± 10 years; 21% female) following isolated CABG. In a secondary analysis, patients were propensity-matched by age, sex, renal function, diabetes and ejection fraction (778 individuals in each group). Results: Indigenous Australians were younger and more likely to be female and current smokers and to have diabetes, hypertension, renal impairment, heart failure and previous CABG (all P < 0.04). Indigenous patients had fewer bypasses with arterial conduits (including less internal mammary artery use) and a higher number of distal vein anastomoses (P < 0.001). Postoperative bleeding rates were higher in indigenous patients (P = 0.001). However, in-hospital and 30-day all-cause mortality and rates of 30-day readmission were similar between both groups, although cardiac mortality was higher in the indigenous cohort (1.5% vs 0.8%, P = 0.02). With propensity-matching, rates of postoperative complications were similar among the two groups, with the exception of bleeding, which remained higher in Indigenous Australians (P = 0.03). Conclusions: Despite procedural differences and higher rates of baseline comorbidities, Indigenous Australians do not have worse short-term outcomes following isolated CABG. Given the higher rates of baseline comorbidities and lower rates of arterial conduit use, it will be essential to determine long-term outcomes. |
| first_indexed | 2025-11-14T10:57:38Z |
| format | Journal Article |
| id | curtin-20.500.11937-73686 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:57:38Z |
| publishDate | 2018 |
| publisher | Blackwell Publishing |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-736862019-07-16T03:31:58Z Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting O'Brien, J. Saxena, A. Reid, Christopher Tran, L. Baker, R. Newcomb, A. Smith, J. Huq, M. Duffy, S. Background: Indigenous Australians have higher rates of cardiovascular disease and comorbidities compared to their non-indigenous counterparts. Aims: We sought to evaluate whether indigenous status per se portends a worse prognosis following isolated coronary artery bypass grafting (CABG). Methods: The outcomes of 778 Indigenous Australians (55 ± 10 years; 32% female) enrolled in the Australian and New Zealand Society of Cardiac and Thoracic Surgeons registry were compared to 36 124 non-Indigenous Australians (66 ± 10 years; 21% female) following isolated CABG. In a secondary analysis, patients were propensity-matched by age, sex, renal function, diabetes and ejection fraction (778 individuals in each group). Results: Indigenous Australians were younger and more likely to be female and current smokers and to have diabetes, hypertension, renal impairment, heart failure and previous CABG (all P < 0.04). Indigenous patients had fewer bypasses with arterial conduits (including less internal mammary artery use) and a higher number of distal vein anastomoses (P < 0.001). Postoperative bleeding rates were higher in indigenous patients (P = 0.001). However, in-hospital and 30-day all-cause mortality and rates of 30-day readmission were similar between both groups, although cardiac mortality was higher in the indigenous cohort (1.5% vs 0.8%, P = 0.02). With propensity-matching, rates of postoperative complications were similar among the two groups, with the exception of bleeding, which remained higher in Indigenous Australians (P = 0.03). Conclusions: Despite procedural differences and higher rates of baseline comorbidities, Indigenous Australians do not have worse short-term outcomes following isolated CABG. Given the higher rates of baseline comorbidities and lower rates of arterial conduit use, it will be essential to determine long-term outcomes. 2018 Journal Article http://hdl.handle.net/20.500.11937/73686 10.1111/imj.13790 Blackwell Publishing restricted |
| spellingShingle | O'Brien, J. Saxena, A. Reid, Christopher Tran, L. Baker, R. Newcomb, A. Smith, J. Huq, M. Duffy, S. Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting |
| title | Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting |
| title_full | Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting |
| title_fullStr | Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting |
| title_full_unstemmed | Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting |
| title_short | Thirty-day outcomes in Indigenous Australians following coronary artery bypass grafting |
| title_sort | thirty-day outcomes in indigenous australians following coronary artery bypass grafting |
| url | http://hdl.handle.net/20.500.11937/73686 |