PLoS ONE
Volume 10, Issue 9, 2015

Are there Ethnic inequalities in revascularisation procedure rate after an ST-elevation myocardial infarction? (Article) (Open Access)

Van Oeffelen A.A.M. , Rittersma S. , Vaartjes I. , Stronks K. , Bots M.L. , Agyemang C.
  • a Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, 3508 GA, Netherlands
  • b Department of Cardiology, University Medical Center Utrecht, Utrecht, 3508 GA, Netherlands
  • c Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, 3508 GA, Netherlands
  • d Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, 1100 DD, Netherlands
  • e Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, 3508 GA, Netherlands
  • f Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, 1100 DD, Netherlands

Abstract

Background: Previously, ethnic inequalities in prognosis after a first acute myocardial infarction were observed in the Netherlands. This might be due to differences in revascularisation rate between ethnic minority groups and ethnic Dutch. Therefore, we investigated inequalities in revascularisation rate after occurrence of an ST-elevation myocardial infarction (STEMI) between first generation ethnic minority groups (henceforth, migrants) and ethnic Dutch. Methods: All STEMI events between 2006 and 2011 were identified in a subset of the Achmea Health Database, which records medical care to persons insured at the Achmea health insurance company, a major health insurance company in the central part of the Netherlands. Ethnic Dutch and migrants from Suriname (Hindustani Surinamese and non-Hindustani Surinamese), Morocco, and Turkey were included (n = 1,765). Multivariable Cox proportional hazards regression analyses were used to identify ethnic inequalities in revascularisation rate (percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)) after a STEMI event. Results: On average, 73.2%of STEMI events were followed by a revascularisation procedure. After adjustment for confounders (age, sex, degree of urbanization) no significant differences in revascularisation rate were found between the ethnic Dutch population and Hindustani Surinamese (HR: 1.04; 0.85-1.27), non-Hindustani Surinamese (HR: 0.98; 0.63-1.51), Moroccan (HR: 0.94; 0.77-1.14), and Turkish migrants (HR: 1.04; 0.88-1.24). Additional adjustment for comorbidity and neighborhood income did not change our findings. Conclusion: Our study suggests no ethnic inequalities in revascularisation rate after a STEMI event. This finding is in agreement with the universally accessible health care system in the Netherlands. © 2015 van Oeffelen et al.

Author Keywords

[No Keywords available]

Index Keywords

Netherlands Dutchman proportional hazards model Myocardial Infarction regression analysis human middle aged Asian continental ancestry group statistics and numerical data ethnic group Turkey (republic) controlled study Aged ethnology Humans migrant ethnic difference Suriname male female Turk (people) Myocardial Revascularization Article coronary artery bypass graft percutaneous coronary intervention heart muscle revascularization ST segment elevation myocardial infarction major clinical study adult health care system Surinamese Moroccan Healthcare Disparities health care disparity Morocco

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84947418579&doi=10.1371%2fjournal.pone.0136415&partnerID=40&md5=ca9e90db50ea4e2ba302f866092e2c1d

DOI: 10.1371/journal.pone.0136415
ISSN: 19326203
Cited by: 4
Original Language: English