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

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.