A review of coronary artery bypass grafting in the Indigenous Australian population

Wiemers, Paul D., Fraser, John F., Marney, Lucy, Yadav, Sumit, and Tam, Robert (2019) A review of coronary artery bypass grafting in the Indigenous Australian population. Heart, Lung and Circulation, 28 (4). pp. 530-538.

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Abstract

Introduction: Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Ischaemic heart disease is a leading contributor to the mortality gap which exists between Indigenous and non-Indigenous Australians.

Methods: We reviewed the literature in regards to Indigenous Australians undergoing coronary artery bypass grafting (CABG) for management of ischaemic heart disease.

Results: Younger patients with higher rates of preventable risk factors constitute the Indigenous Australian CABG population. Indigenous Australian females are over-represented in series to date. High rates of left ventricular dysfunction are seen in the Indigenous CABG cohorts potentially reflecting barriers to medical care or the influence of high rates of diabetes observed in the Indigenous Australian population.

The distribution of coronary artery disease appears to differ between Indigenous Australian and non-Indigenous CABG cohorts likely reflecting a difference in the referral patterns of the two population groups with diabetes again likely influencing management decisions.

Reduced utilisation of arterial conduits in Indigenous Australian cohorts has been identified in a number of series. This is of particular concern given the younger age structure of the Indigenous Australian cohorts. Indigenous Australian patients suffer excess morbidity and mortality in the longer term after undergoing CABG. Ventricular dysfunction and excess comorbidities in the Indigenous Australian CABG population appear largely responsible for this.

Conclusion: Excess morbidity and mortality endured by Indigenous Australians in the longer term following CABG appears largely contributed to by higher rates of ventricular dysfunction and comorbidities in the Indigenous Australian CABG population. Maximising internal mammary artery use and continued focus on strategies to reduce the impact of diabetes, renal impairment and heart failure in the Indigenous Australian population is essential to reduce the mortality gap experienced by Indigenous Australians secondary to ischaemic heart disease.

Item ID: 57733
Item Type: Article (Research - C1)
ISSN: 1444-2892
Keywords: Indigenous Australians, Coronary artery disease, Coronary artery bypass grafting (CABG), Cardiovascular risk factors
Copyright Information: © 2018 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
Funders: Queensland Government Office of Health and Medical Research
Date Deposited: 27 Mar 2019 07:35
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 50%
45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450409 Aboriginal and Torres Strait Islander health services @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 50%
92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 50%
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