The use of coronary revascularisation procedures in urban Australian Aboriginals and a matched general population coronary procedures in Aboriginals

Abstract

Background: Coronary revascularisation procedures may be under-used for Aboriginal Australians with ischaemic heart disease (IHD). We compared the use of procedures in an urban Aboriginal population and a non-Aboriginal external comparison group.

Methods: The Perth Aboriginal Atherosclerosis Risk (PAARS) cohort (n=998) and 3695 age- and sex-matched non-Aboriginals were electronically linked to Western Australian hospital morbidity data to identify admissions and revascularisation procedures between 1980 and 2006.

Results: There were 731 admissions for IHD for 983 PAARS participants with hospital admissions and 391 in 3150 non-Aboriginals. There were 136 first procedures overall; 43% of Aboriginals having a procedure were women versus 18.5% of non-Aboriginals. 41% of Aboriginal patients and 48% of non-Aboriginals had procedures (p=0.12). Aboriginals were more likely to have coronary artery bypass grafts (CABG) (40.5%) than a percutaneous coronary intervention (PCI), compared to the general population (23%, p=0.02). The proportion of first procedures for acute coronary syndrome (ACS) admissions was 61% for both groups, 80% and 85%, respectively, being PCI.

Conclusions: Coronary revascularisation procedures for IHD were used with equal frequency in Aboriginal people and matched non-Aboriginals. Aboriginal people were more likely to have CABG than PCI. Revascularisation rate and type in ACS admissions were the same.