Abstract P171: Ethnic Inequalities In Cardiac Revascularization After Acute Coronary Syndrome

Abstract

Background: Extensive literature in the USA reports lower revascularization rates after coronary heart disease among African Americans than among White Americans. Ethnic differences in revascularization procedures in European countries with an egalitarian health care system are rarely studied. We investigated disparities in revascularization procedures after an acute coronary syndrome (ACS) between ethnic minority groups and the Dutch majority population. Methods: All ACS events between 2006 and 2011 were identified in the Agis insurance Health Database using Diagnosis Treatment Combinations. Multivariable logistic regression analyses (adjusted for age, sex, ACS type, degree of urbanisation, socioeconomic status and comorbidity) were used to identify ethnic differences in revascularization procedures (percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)) within 30 days after the ACS event. Results: On average, after 41.3% of all ACS events a revascularization procedure was performed. In the fully adjusted model, no difference in revascularization rate between the Dutch majority population and the ethnic minority groups under study were found (Moroccan (1.05; 0.77-1.43), Turkish (0.94; 0.75-1.18), Hindustani Surinamese (0.92; 0.70-1.21), and non-Hindustani Surinamese (1.15; 0.61-2.17)). Also age-stratified results did not show significant differences. Conclusion: In the Netherlands, a country with an egalitarian health care system, no ethnic inequalities in revascularization rate within 30 days after an acute coronary syndrome were observed. ACS type, degree of urbanisation, SES, and comorbidity did not influence the findings. Future research should elucidate whether disease severity may have obscured results.