The following article is part of conference coverage from the American College of Cardiology (ACC.20) /World Congress of Cardiology. The Cardiology Advisor‘s staff is reporting on research conducted by leading experts in cardiology. Check back for the latest news from the ACC.20.

Aboriginal and Torres Strait Islander (ATSI) status may predict death in individuals with acute coronary syndrome (ACS), according to research intended to be presented at the American College of Cardiology’s 69th Annual Scientific Session.

As ATSI Australians are known to have poorer health outcomes compared with nonindigenous Australians, researchers sought to examine the outcomes of acute coronary syndrome and heart failure (HF) in indigenous vs nonindigenous Australian populations. In this study, the outcomes of all patients (≥18 years) admitted to a Hunter New England Local Health District facility in New Lambton Heights, Australia, between 2007 and 2016 for ACS or heart failure were examined. ACS and heart failure were determined according to International Classification of Disease, 10th Revision, codes I-20/I-21 and I-50, respectively. All-cause mortality and all-cause readmission were the study’s primary outcomes.

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In this cohort,22,120 patients had ACS (5% ATSI) and 20,480 patients had heart failure (3% ATSI). Indigenous vs nonindigenous patients were found to be younger (by an average 14 years for ACS and 15 years for heart failure; P <.001), to be more likely to live in a nonmetropolitan area, to have diabetes, and to have a history of smoking. After adjusting for age, mortality 1 year after presentation was found to be higher in indigenous vs nonindigenous patients with heart failure (P =.01) and ACS (P =.03). In a multivariate analysis, indigenous status was found to be a predictor of mortality in the ACS cohort (hazard ratio [HR], 1.27; P <.001), but not in the heart failure cohort (P =.89). However, indigenous status was an independent predictor of readmission for HF (HR, 1.31; P <.001) and for ACS (HR, 1.5; P <.001).

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“Indigenous status was not an independent predictor of mortality in [the heart failure] cohort but was a predictor in [patients with] ACS,” concluded the study authors.


Al-Omary M, McGee M, Sugito S, et al. Outcomes of heart failure and acute coronary syndrome in indigenous population in a regional Australian setting. Intended to be presented at: American College of Cardiology’s 69th Annual Scientific Session; March 28-30, 2020; Chicago, IL. Presentation 905-08.

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