| Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity. | |
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MedLine Citation:
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PMID: 21798989 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Judith M Katzenellenbogen; Frank M Sanfilippo; Michael St Hobbs; Tom G Briffa; Steve C Ridout; Matthew W Knuiman; Lyn Dimer; Kate P Taylor; Peter L Thompson; Sandra C Thompson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-28 |
Journal Detail:
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Title: European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology Volume: - ISSN: 1741-8275 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101192000 Medline TA: Eur J Cardiovasc Prev Rehabil Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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University of Western Australia, Perth, Australia; Curtin University, Perth, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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