scholarly journals Revascularization Procedures after Acute Myocardial Infarction: Are there Disparities between Ethnic Minority Groups and the Dutch Majority Population?

2015 ◽  
Vol 44 (suppl_1) ◽  
pp. i119-i119
Author(s):  
I. Vaartjes
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Majority Population ◽  
Revascularization Procedures

Abstract P171: Ethnic Inequalities In Cardiac Revascularization After Acute Coronary Syndrome

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Louise Van Oeffelen ◽  
Ilonca Vaartjes ◽  
Kariien Stronks ◽  
Michiel Bots ◽  
Charles Agyemang
Keyword(s):  
Health Care ◽  
Acute Coronary Syndrome ◽  
Ethnic Minority ◽  
Health Care System ◽  
Ethnic Differences ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Coronary Syndrome ◽  
Majority Population ◽  
Revascularization Procedures

Background: Extensive literature in the USA reports lower revascularization rates after coronary heart disease among African Americans than among White Americans. Ethnic differences in revascularization procedures in European countries with an egalitarian health care system are rarely studied. We investigated disparities in revascularization procedures after an acute coronary syndrome (ACS) between ethnic minority groups and the Dutch majority population. Methods: All ACS events between 2006 and 2011 were identified in the Agis insurance Health Database using Diagnosis Treatment Combinations. Multivariable logistic regression analyses (adjusted for age, sex, ACS type, degree of urbanisation, socioeconomic status and comorbidity) were used to identify ethnic differences in revascularization procedures (percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)) within 30 days after the ACS event. Results: On average, after 41.3% of all ACS events a revascularization procedure was performed. In the fully adjusted model, no difference in revascularization rate between the Dutch majority population and the ethnic minority groups under study were found (Moroccan (1.05; 0.77-1.43), Turkish (0.94; 0.75-1.18), Hindustani Surinamese (0.92; 0.70-1.21), and non-Hindustani Surinamese (1.15; 0.61-2.17)). Also age-stratified results did not show significant differences. Conclusion: In the Netherlands, a country with an egalitarian health care system, no ethnic inequalities in revascularization rate within 30 days after an acute coronary syndrome were observed. ACS type, degree of urbanisation, SES, and comorbidity did not influence the findings. Future research should elucidate whether disease severity may have obscured results.

Abstract P169: Ethnic Disparities In Short- And Long-term Prognosis After A First Cardiovascular Hospitalization

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Louise Van Oeffelen ◽  
Charles Agyemang ◽  
Carla Koopman ◽  
Karien Stronks ◽  
Michiel Bots ◽  
...  
Keyword(s):  
Ethnic Minority ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Ethnic Minority Groups ◽  
Readmission Rates ◽  
Majority Population ◽  
Short And Long Term ◽  
Migrant Groups ◽  
Long Term Mortality

Introduction: Ethnic disparities in prognosis after a cardiovascular event have been reported. We investigated differences in mortality and readmission after a first hospital admission for total cardiovascular disease (CVD), AMI, CVA, peripheral arterial disease (PAD), and congestive heart failure (CHF) between several ethnic minority groups and the Dutch majority population. Methods: A nationwide prospective cohort of CVD patients hospitalized between 1998 and 2010 was constructed (N=776,574). Differences in short- and long-term mortality and readmission (0-28 days after admission and 28 days-5 years after admission respectively) between first generation ethnic minority groups (henceforth: migrants) and the Dutch majority population were calculated using multivariable Cox proportional hazard models . Results: In particular mortality after AMI and CVA was higher in migrants compared to the Dutch majority population, except for Moroccans. Short- (HR 1.36; 1.07-1.74) and long-term ( HR 1.45; 1.20-1.75) mortality after CVD was the highest in Chinese migrants. Short-term readmission rates were similar between migrants and the Dutch majority population, except after AMI where mainly lower rates were found (HR:0.37-1.26). Long-term readmission rates were also similar to the Dutch majority population, except after CHF where readmission rates were lower (HR varies between 0.67-0.95), and after AMI where readmission rates for AMI were higher (HR varies between 1.24-1.83). Conclusion: Short- and long-term mortality after CVD is higher in migrant groups than in the Dutch majority population, except after CHF. Differences in readmission rates were more similar to the Dutch majority population, with some fluctuations between sub diseases and migrant groups.

Gene-environment Interaction on the Risk of Type 2 Diabetes Among Ethnic Minority Populations Living in Europe and North America: A Systematic Review

2020 ◽  
Vol 16 (5) ◽  
pp. 457-470 ◽  
Author(s):  
Mohammad H. Zafarmand ◽  
Parvin Tajik ◽  
René Spijker ◽  
Charles Agyemang
Keyword(s):  
Type 2 Diabetes ◽  
North America ◽  
Ethnic Minority ◽  
Ethnic Minorities ◽  
Minority Groups ◽  
Environment Interaction ◽  
Ethnic Minority Groups ◽  
Gene Environment Interaction ◽  
Gene Environment

Background: The body of evidence on gene-environment interaction (GEI) related to type 2 diabetes (T2D) has grown in the recent years. However, most studies on GEI have sought to explain variation within individuals of European ancestry and results among ethnic minority groups are inconclusive. Objective: To investigate any interaction between a gene and an environmental factor in relation to T2D among ethnic minority groups living in Europe and North America. Methods: We systematically searched Medline and EMBASE databases for the published literature in English up to 25th March 2019. The screening, data extraction and quality assessment were performed by reviewers independently. Results: 1068 studies identified through our search, of which nine cohorts of six studies evaluating several different GEIs were included. The mean follow-up time in the included studies ranged from 5 to 25.7 years. Most studies were relatively small scale and few provided replication data. All studies included in the review included ethnic minorities from North America (Native-Americans, African- Americans, and Aboriginal Canadian), none of the studies in Europe assessed GEI in relation to T2D incident in ethnic minorities. The only significant GEI among ethnic minorities was HNF1A rs137853240 and smoking on T2D incident among Native-Canadians (Pinteraction = 0.006). Conclusion: There is a need for more studies on GEI among ethnicities, broadening the spectrum of ethnic minority groups being investigated, performing more discovery using genome-wide approaches, larger sample sizes for these studies by collaborating efforts such as the InterConnect approach, and developing a more standardized method of reporting GEI studies are discussed.

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