Disparities in the incidence of acute myocardial infarction: long‐term trends from the Hunter region

Davies, Allan; Naudin, Crystal; Al-Omary, M.; Khan, Akhtar A.; Oldmeadow, Christopher; Jones, Mark; Bastian, B.; Bhagwandeen, Rohan; Fletcher, Peter; Leitch, James; Boyle, Andrew

doi:10.1111/imj.13399

Cited by 8 publications

(5 citation statements)

References 35 publications

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“… 17–19 This study supports evidence for greater and targeted efforts and resources in remote communities to address cardiac health needs. 21 A selective approach of increasing hospital care without adequate primary care is unlikely to be sufficient to close the CVD survival gap. AMI survival can be improved by better public awareness and responsiveness of health services, advances in early risk assessment and management, and use of antithrombotic, antihypertensive and lipid-lowering drugs.…”

Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction incidence and survival in Aboriginal and non-Aboriginal populations: an observational study in the Northern Territory of Australia, 1992–2014

Coffey

Zhao²,

Condon

et al. 2020

BMJ Open

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ObjectivesTo examine long-term trends in acute myocardial infarction (AMI) incidence and survival among Aboriginal and non-Aboriginal people.DesignRetrospective cohort study.Setting, participantsAll first AMI hospital cases and deaths due to ischaemic heart disease in the Northern Territory of Australia (NT), 1992–2014.Main outcome measuresAge standardised incidence, survival and mortality.ResultsThe upward trend in Aboriginal AMI incidence plateaued around 2007 for males and 2001 for females. AMI incidence decreased for non-Aboriginal population, consistent with the national trends. AMI incidence was higher and survival lower for males, for Aboriginal people and in older age groups. In 2014, the age standardised incidence was 881 and 579 per 100 000 for Aboriginal males and females, respectively, compared with 290 and 187 per 100 000 for non-Aboriginal counterparts. The incidence disparity between Aboriginal and non-Aboriginal population was much greater in younger than older age groups. Survival after an AMI improved over time, and more so for Aboriginal than non-Aboriginal patients, because of a decrease in prehospital deaths and improved survival of hospitalised cases.ConclusionsThere was an important breakpoint in increasing trends of Aboriginal AMI incidence between 2001 and 2007. The disparity in AMI survival between the NT Aboriginal and non-Aboriginal populations reduced over time as survival improved for both populations.

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Section: Discussionmentioning

confidence: 99%

Acute myocardial infarction incidence and survival in Aboriginal and non-Aboriginal populations: an observational study in the Northern Territory of Australia, 1992–2014

Coffey

Zhao²,

Condon

et al. 2020

BMJ Open

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“…Retrospective cohort analysis involving patient data collected from the Hunter Area Cardiac and Stroke Outcomes Unit (HACSOU), which prospectively identified all admissions of MI in the Hunter‐New England Health district. The HACSOU has been previously utilised in several studies 2,18 . The use of de‐identified patient information from the database was approved by the Hunter New England Human Research Ethics Committee.…”

Section: Methodsmentioning

confidence: 99%

“…Although mortality from ischaemic heart disease has been steadily declining, it remains the leading cause of death for Australian adults 1 . A recent retrospective cohort analysis covering a large local health district in New South Wales (NSW) determined that although incidence of myocardial infarction (MI) was decreasing in metropolitan regions, an inverse trend was seen in rural areas, with an increase of 8% between 1996 and 2013 2 . This finding is mirrored by other cohorts which have shown that the risk of ischaemic heart disease is not uniform across NSW, with higher rates in the remote western regions of the state 3 …”

Section: Introductionmentioning

confidence: 99%

Impact of fast‐food outlet density on incidence of myocardial infarction in the Hunter region

Saluja

Davies

Oldmeadow

et al. 2021

Internal Medicine Journal

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Background There is an established association between fast‐food consumption and metabolic diseases. Some studies also suggest that calorie‐dense food promotes a proinflammatory response, which is itself linked with myocardial infarction (MI). Whether increased fast‐food availability is a risk factor for MI remains unknown. Aim To investigate the role of fast‐food outlet density (FFD) as a novel environmental risk factor for MI in the Hunter region, New South Wales (NSW). Methods We conducted a retrospective cohort study using a database of all MI events between 1996 and 2013, extracted from the Hunter Cardiac and Stroke Outcomes unit. FFD was calculated for each local government area (LGA) of the Hunter region, allowing for a comparative analysis. Stratification by fast‐food outlet data and LGA resulted in a total of 3070 cases. Weighted linear regression was used to investigate the role of FFD on incidence of MI in regional and rural Australia. Results FFD was positively correlated with rates of MI, remaining consistent in both single and multivariate predictor models adjusting for age, obesity, hyperlipidaemia, hypertension, smoking status, diabetes and socioeconomic status (P < 0.001). An increase of one fast‐food outlet corresponded with four additional cases of MI per 100 000 people per year (4.07, 95% confidence interval, 3.86–4.28). Conclusions FFD was positively associated with incidence of MI in both rural and metropolitan areas of NSW. This relationship remained consistent after multivariate adjustment for standard cardiovascular risk factors, highlighting the importance of an individual's food environment as a potential contributor towards their health.

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“…By restoring blood flow, the bypass helps to alleviate anginal symptoms and restore function and viability to the ischemic myocardium. The most frequent major surgical surgery, over 400,000 CABG procedures, is carried out per year; however, as the utilization of other treatments, such as medicinal therapy and percutaneous coronary intervention (PCI), has grown, surgical trends have fallen [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Percutaneous Coronary Intervention (PCI) and Coronary Bypass Grafting (CABG) Outcomes in Indigenous vs. Non-Indigenous Australians

Karim

2024

Cureus

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Introduction: A major cause of death, coronary artery disease (CAD) often necessitates invasive procedures like coronary bypass grafting (CABG) and percutaneous coronary intervention (PCI). Cardiovascular outcomes vary between indigenous and non-indigenous Australian people; however, comprehensive knowledge of these differences is absent.Methodology: To compare PCI and CABG results between indigenous and non-indigenous Australians, a systematic review and meta-analysis were carried out. Included were 10 retrospective observational studies that examined mortality, cardiovascular events, comorbidities, and operative success rates. Databases spanning 2014 to 2024 were searched, and research that directly compared Australia's indigenous and nonindigenous populations was among the inclusion criteria.Results: Within 30 days of surgery, indigenous Australians receiving PCI had greater rates of comorbidities and were at higher risk of long-term mortality and MACE. Similarly, there was a greater long-term death rate among indigenous patients following CABG. Cultural safety, socioeconomic factors, and regional factors affecting treatment delays and access to care all affected disparities. For 30-day mortality, the pooled analysis shows an odds ratio of 1.04 (95% CI 0.78, 1.40), indicating no meaningful difference. The total odds ratio for unfavorable occurrences is 1.07 (95% CI 0.86, 1.33), meaning there is no statistically significant difference between Indigenous groups and those that are not. Conclusion: Indigenous Australians continue to have worse cardiovascular outcomes after PCI and CABG procedures, even with similar procedural success rates. To ensure equitable cardiovascular outcomes for indigenous groups, targeted therapies targeting underlying risk factors, increased access to culturally appropriate care, and decreased obstacles to healthcare access are critical.

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Disparities in the incidence of acute myocardial infarction: long‐term trends from the Hunter region

Abstract: Between 1996 and 2013 in the Hunter region, the adjusted incidence of AMI increased for regional patients compared to metropolitan patients with a trend towards a higher adjusted incidence of AMI in the indigenous population.

Cited by 8 publications

References 35 publications

Acute myocardial infarction incidence and survival in Aboriginal and non-Aboriginal populations: an observational study in the Northern Territory of Australia, 1992–2014

Acute myocardial infarction incidence and survival in Aboriginal and non-Aboriginal populations: an observational study in the Northern Territory of Australia, 1992–2014

Impact of fast‐food outlet density on incidence of myocardial infarction in the Hunter region

A Systematic Review and Meta-Analysis of Percutaneous Coronary Intervention (PCI) and Coronary Bypass Grafting (CABG) Outcomes in Indigenous vs. Non-Indigenous Australians

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