Incidence and survival after acute myocardial infarction in Indigenous and non-Indigenous people in the Northern Territory, 1992-2004

J YOU, John Condon, Y ZHAO, S GUTHRIDGE

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To estimate the incidence and survival rates of acute myocardial infarction (AMI) for Northern Territory Indigenous and non-Indigenous populations. Design and participants: Retrospective cohort study for all new AMI cases recorded in hospital inpatient data or registered as an ischaemic heart disease (IHD) death between 1992 and 2004. Main outcome measures: Population-based incidence and survival rates by age, sex, Indigenous status, remoteness of residence and year of diagnosis. Results: Over the 13-year study period, the incidence of AMI increased 60% in the NT Indigenous population (incidence rate ratio [IRR], 1.04; 95% CI, 1.02-1.06), but decreased 20% in the non-Indigenous population (IRR, 0.98; 95% CI, 0.97-1.00). Over the same period, there was an improvement in all-cases survival (ie, survival with and without hospital admission) for the NT Indigenous population due to a reduction in deaths both pre-hospital and after hospital admission (death rates reduced by 56% and 50%, respectively). The non-Indigenous all-cases death rate was reduced by 29% as a consequence of improved survival after hospital admission; there was no significant change in pre-hospital survival in this population. Important factors that affected outcome in all people after AMI were sex (better survival for women), age (survival declined with increasing age), remoteness (worse outcomes for non-Indigenous residents of remote areas), year of diagnosis and Indigenous status (hazard ratio, 1.44; 95% CI, 1.21-1.70). Conclusions: Our results show that the increasing IHD mortality in the NT Indigenous population is a consequence of a rise in AMI incidence, while at the same time there has been some improvement in Indigenous AMI survival rates. The simultaneous decrease in IHD mortality in NT non-Indigenous people was a result of reduced AMI incidence and improved survival after AMI in those admitted to hospital. Our results inform population-specific strategies for a systemwide response to AMI management.
    Original languageEnglish
    Pages (from-to)298-302
    Number of pages5
    JournalMedical Journal of Australia
    Volume190
    Issue number6
    Publication statusPublished - 2009

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    Northern Territory
    Myocardial Infarction
    Survival
    Incidence
    Population Groups
    Myocardial Ischemia
    Survival Rate
    Mortality
    Population
    Cohort Studies
    Inpatients
    Retrospective Studies
    Outcome Assessment (Health Care)

    Cite this

    @article{f85edf0c0b6141698050be8c001cecfe,
    title = "Incidence and survival after acute myocardial infarction in Indigenous and non-Indigenous people in the Northern Territory, 1992-2004",
    abstract = "Objective: To estimate the incidence and survival rates of acute myocardial infarction (AMI) for Northern Territory Indigenous and non-Indigenous populations. Design and participants: Retrospective cohort study for all new AMI cases recorded in hospital inpatient data or registered as an ischaemic heart disease (IHD) death between 1992 and 2004. Main outcome measures: Population-based incidence and survival rates by age, sex, Indigenous status, remoteness of residence and year of diagnosis. Results: Over the 13-year study period, the incidence of AMI increased 60{\%} in the NT Indigenous population (incidence rate ratio [IRR], 1.04; 95{\%} CI, 1.02-1.06), but decreased 20{\%} in the non-Indigenous population (IRR, 0.98; 95{\%} CI, 0.97-1.00). Over the same period, there was an improvement in all-cases survival (ie, survival with and without hospital admission) for the NT Indigenous population due to a reduction in deaths both pre-hospital and after hospital admission (death rates reduced by 56{\%} and 50{\%}, respectively). The non-Indigenous all-cases death rate was reduced by 29{\%} as a consequence of improved survival after hospital admission; there was no significant change in pre-hospital survival in this population. Important factors that affected outcome in all people after AMI were sex (better survival for women), age (survival declined with increasing age), remoteness (worse outcomes for non-Indigenous residents of remote areas), year of diagnosis and Indigenous status (hazard ratio, 1.44; 95{\%} CI, 1.21-1.70). Conclusions: Our results show that the increasing IHD mortality in the NT Indigenous population is a consequence of a rise in AMI incidence, while at the same time there has been some improvement in Indigenous AMI survival rates. The simultaneous decrease in IHD mortality in NT non-Indigenous people was a result of reduced AMI incidence and improved survival after AMI in those admitted to hospital. Our results inform population-specific strategies for a systemwide response to AMI management.",
    keywords = "acute heart infarction, adult, age, aged, article, Australia, controlled study, female, hospital admission, human, incidence, indigenous people, major clinical study, male, mortality, outcome assessment, sex difference, survival rate, urban rural difference, Adult, Age Distribution, Aged, Cohort Studies, Female, Health Services Accessibility, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Northern Territory, Oceanic Ancestry Group, Odds Ratio, Retrospective Studies, Risk Factors, Sex Distribution, Young Adult",
    author = "J YOU and John Condon and Y ZHAO and S GUTHRIDGE",
    year = "2009",
    language = "English",
    volume = "190",
    pages = "298--302",
    journal = "Medical Journal of Australia",
    issn = "0025-729X",
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    }

    Incidence and survival after acute myocardial infarction in Indigenous and non-Indigenous people in the Northern Territory, 1992-2004. / YOU, J; Condon, John; ZHAO, Y; GUTHRIDGE, S.

    In: Medical Journal of Australia, Vol. 190, No. 6, 2009, p. 298-302.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Incidence and survival after acute myocardial infarction in Indigenous and non-Indigenous people in the Northern Territory, 1992-2004

    AU - YOU, J

    AU - Condon, John

    AU - ZHAO, Y

    AU - GUTHRIDGE, S

    PY - 2009

    Y1 - 2009

    N2 - Objective: To estimate the incidence and survival rates of acute myocardial infarction (AMI) for Northern Territory Indigenous and non-Indigenous populations. Design and participants: Retrospective cohort study for all new AMI cases recorded in hospital inpatient data or registered as an ischaemic heart disease (IHD) death between 1992 and 2004. Main outcome measures: Population-based incidence and survival rates by age, sex, Indigenous status, remoteness of residence and year of diagnosis. Results: Over the 13-year study period, the incidence of AMI increased 60% in the NT Indigenous population (incidence rate ratio [IRR], 1.04; 95% CI, 1.02-1.06), but decreased 20% in the non-Indigenous population (IRR, 0.98; 95% CI, 0.97-1.00). Over the same period, there was an improvement in all-cases survival (ie, survival with and without hospital admission) for the NT Indigenous population due to a reduction in deaths both pre-hospital and after hospital admission (death rates reduced by 56% and 50%, respectively). The non-Indigenous all-cases death rate was reduced by 29% as a consequence of improved survival after hospital admission; there was no significant change in pre-hospital survival in this population. Important factors that affected outcome in all people after AMI were sex (better survival for women), age (survival declined with increasing age), remoteness (worse outcomes for non-Indigenous residents of remote areas), year of diagnosis and Indigenous status (hazard ratio, 1.44; 95% CI, 1.21-1.70). Conclusions: Our results show that the increasing IHD mortality in the NT Indigenous population is a consequence of a rise in AMI incidence, while at the same time there has been some improvement in Indigenous AMI survival rates. The simultaneous decrease in IHD mortality in NT non-Indigenous people was a result of reduced AMI incidence and improved survival after AMI in those admitted to hospital. Our results inform population-specific strategies for a systemwide response to AMI management.

    AB - Objective: To estimate the incidence and survival rates of acute myocardial infarction (AMI) for Northern Territory Indigenous and non-Indigenous populations. Design and participants: Retrospective cohort study for all new AMI cases recorded in hospital inpatient data or registered as an ischaemic heart disease (IHD) death between 1992 and 2004. Main outcome measures: Population-based incidence and survival rates by age, sex, Indigenous status, remoteness of residence and year of diagnosis. Results: Over the 13-year study period, the incidence of AMI increased 60% in the NT Indigenous population (incidence rate ratio [IRR], 1.04; 95% CI, 1.02-1.06), but decreased 20% in the non-Indigenous population (IRR, 0.98; 95% CI, 0.97-1.00). Over the same period, there was an improvement in all-cases survival (ie, survival with and without hospital admission) for the NT Indigenous population due to a reduction in deaths both pre-hospital and after hospital admission (death rates reduced by 56% and 50%, respectively). The non-Indigenous all-cases death rate was reduced by 29% as a consequence of improved survival after hospital admission; there was no significant change in pre-hospital survival in this population. Important factors that affected outcome in all people after AMI were sex (better survival for women), age (survival declined with increasing age), remoteness (worse outcomes for non-Indigenous residents of remote areas), year of diagnosis and Indigenous status (hazard ratio, 1.44; 95% CI, 1.21-1.70). Conclusions: Our results show that the increasing IHD mortality in the NT Indigenous population is a consequence of a rise in AMI incidence, while at the same time there has been some improvement in Indigenous AMI survival rates. The simultaneous decrease in IHD mortality in NT non-Indigenous people was a result of reduced AMI incidence and improved survival after AMI in those admitted to hospital. Our results inform population-specific strategies for a systemwide response to AMI management.

    KW - acute heart infarction

    KW - adult

    KW - age

    KW - aged

    KW - article

    KW - Australia

    KW - controlled study

    KW - female

    KW - hospital admission

    KW - human

    KW - incidence

    KW - indigenous people

    KW - major clinical study

    KW - male

    KW - mortality

    KW - outcome assessment

    KW - sex difference

    KW - survival rate

    KW - urban rural difference

    KW - Adult

    KW - Age Distribution

    KW - Aged

    KW - Cohort Studies

    KW - Female

    KW - Health Services Accessibility

    KW - Humans

    KW - Incidence

    KW - Male

    KW - Middle Aged

    KW - Myocardial Infarction

    KW - Northern Territory

    KW - Oceanic Ancestry Group

    KW - Odds Ratio

    KW - Retrospective Studies

    KW - Risk Factors

    KW - Sex Distribution

    KW - Young Adult

    M3 - Article

    VL - 190

    SP - 298

    EP - 302

    JO - Medical Journal of Australia

    JF - Medical Journal of Australia

    SN - 0025-729X

    IS - 6

    ER -