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dc.contributor.authorKatzenellenbogen, Judith M.
dc.contributor.authorSanfilippo, F.
dc.contributor.authorHobbs, M.
dc.contributor.authorBriffa, T.
dc.contributor.authorRidout, S.
dc.contributor.authorKnuiman, M.
dc.contributor.authorDimer, L.
dc.contributor.authorTaylor, Kate
dc.contributor.authorThompson, P.
dc.contributor.authorThompson, S.
dc.identifier.citationKatzenellenbogen, Judith M. and Sanfilippo, Frank M. and Hobbs, Michael ST and Briffa, Tom G. and Ridout, S. C. and Knuiman, Mathew W. and Dimer, Lyn and Taylor, Kate P. and Thompson, Peter L. and Thompson, Sandra C. 2011. Aboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity. European Journal of Cardiovascular Prevention and Rehabilitation. 19 (5): pp. 1-8.

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.

dc.publisherSage Publications Ltd.
dc.subjectmyocardial infarction
dc.subjectsocial differentials
dc.subjectcardiovascular outcomes
dc.titleAboriginal to non-Aboriginal differentials in 2-year outcomes following non-fatal first-ever acute MI persist after adjustment for comorbidity
dc.typeJournal Article
dcterms.source.volumeon line before print
dcterms.source.titleEuropean Journal of Cardiovascular Prevention and Rehabilitation
curtin.departmentCentre for International Health (Curtin Research Centre)
curtin.accessStatusFulltext not available

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