Home > Review Articles > Twenty-eight day and one-year case fatality after hospitalisation with an acute coronary syndrome: a nationwide data linkage study

Twenty-eight day and one-year case fatality after hospitalisation with an acute coronary syndrome: a nationwide data linkage study

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From Māori Health Review Issue 51
Authors:
  • Grey C et al.
Summary:

This study sought to determine 28-day and 1-year case fatality among all New Zealand residents hospitalised with acute coronary syndromes (ACS) between 2007 and 2009 (n=42,920), who were followed for 1 year using individual patient linkage of national hospitalisation and mortality datasets. Case fatality increased steeply with age. In Cox-proportional hazards analysis, Māori and Pacific people had 1.5 times the risk of 28-day, and twice the risk of 1-year, mortality as Europeans/ Others. Compared with having a high socioeconomic status (SES), having a low SES was associated with significantly higher mortality at 28 days (but not 1 year). Patients with unstable angina had half the risk of short-term mortality as non-ST-elevation myocardial infarction (NSTEMI) patients, whereas STEMI patients had double the NSTEMI risk.

Comment:
The findings have confirmed previous research that case fatality (likelihood of dying from a coronary event) was not only higher for Māori and Pacific people in the short term, but then increased over time. Some suggest that inequities in post-ACS management (i.e., timeliness of surgical intervention) between Māori and non-Māori may explain disparities in ACS outcomes.
Reference: Aust N Z J Public Health 2014;38(3):216-20
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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