Department of Cardiology, Townsville University Hospital, Douglas, Qld, Australia; Department of Cardiology, Gold Coast University Hospital, Southport, Qld, Australia.
Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Qld, Australia; Australian Institute of Tropical Health and Medicine Health, James Cook University, Townsville, Qld, Australia.
Heart Lung Circ. 2021 Aug;30(8):1193-1199. doi: 10.1016/j.hlc.2020.11.006. Epub 2021 Mar 9.
Coronary artery disease (CAD) remains the leading cause of death amongst Indigenous Australians accounting for 12.1% of all deaths in this population. However, there is little evidence to suggest that Indigenous status is an independent risk factor for the development of coronary artery disease. This study assessed the association between Indigenous status and the severity of CAD in patients presenting with chest pain at a regional hospital emergency department.
This was a retrospective single-centre audit over 12 months from January to December 2017. Charts were reviewed for both Indigenous and non-Indigenous patients 18 years and older who presented with chest pain and subsequently underwent an invasive coronary angiogram. Multivariable logistic regression was performed to examine the association of Indigenous status with the severity of CAD.
Indigenous patients are 2.7 times more likely to experience significant CAD compared to non-Indigenous patients (Adjusted odds ratio [AOR]=2.73, 95% CI [1.38, 5.39], p≤0.001) even after adjusting for other risk factors. Those aged 65 years and older are more prone to significant CAD (AOR=2.96, 95% CI [1.12, 7.78], p=0.03), while women were less likely to have significant CAD compared to men, (AOR=0.46, 95% CI [0.27, 0.78], p<0.01).
In this study cohort, our analysis indicates that there is a strong association between Indigenous status and significant coronary artery disease, independent of the increased burden of traditional cardiovascular risk factors among Indigenous Australians.
冠心病（CAD）仍然是澳大利亚原住民的主要死因，占该人群所有死亡人数的 12.1%。然而，几乎没有证据表明原住民身份是冠心病发展的独立危险因素。本研究评估了在地区医院急诊部门出现胸痛的患者中，原住民身份与 CAD 严重程度之间的关系。
这是一项为期 12 个月的回顾性单中心研究，时间为 2017 年 1 月至 12 月。对 18 岁及以上的原住民和非原住民胸痛患者进行了回顾性分析，这些患者随后接受了有创性冠状动脉造影。采用多变量逻辑回归分析原住民身份与 CAD 严重程度之间的关联。
与非原住民患者相比，原住民患者发生严重 CAD 的可能性高 2.7 倍（调整后的优势比 [AOR]=2.73，95%置信区间 [1.38, 5.39]，p≤0.001），即使在调整了其他危险因素后也是如此。65 岁及以上的患者更容易发生严重 CAD（AOR=2.96，95%置信区间 [1.12, 7.78]，p=0.03），而女性发生严重 CAD 的可能性低于男性（AOR=0.46，95%置信区间 [0.27, 0.78]，p<0.01）。
在本研究队列中，我们的分析表明，原住民身份与严重的冠状动脉疾病之间存在很强的关联，独立于澳大利亚原住民中传统心血管危险因素的负担增加。
