2023
Authors
Nikki J Earle, Katrina K Poppe, Anna Rolleston, Anna Pilbrow, Sara Aish, Kathryn Bradbury, Yeunhyang Choi, Gerry Devlin, Patrick A Gladding, Corina Grey, Wil Harrison, Kimiora Henare, Joanna Howson, Andrew Kerr, Thomas Lumley, Vijaya Pera, Graeme Porter, Ralph Stewart, Richard W Troughton, Helen Wihongi, A Mark Richards, Vicky A Cameron, Malcolm E Legget, Robert N Doughty
Abstract
The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) was established to investigate the drivers of secondary events after first-time acute coronary syndrome (ACS), including addressing inequitable outcomes by ethnicity. Herein, the first clinical outcomes and prognostic modelling approach are reported.
Of the 2015 MENZACS participants (mean age 61 years, 79% male, 73% European, 14% Māori, 5% Pacific people), 2003 were alive at discharge. Of the 2003, 416 (20.8%) experienced all-cause death/cardiovascular readmission over a median of 3.5 years. In a simple model, age, male sex, Māori ethnicity and NT-proBNP levels were significant predictors of outcome. After adjustment for the clinical summary score, which includes age and sex, NT-proBNP and ethnicity were no longer statistically significant.
In 2015 patients with first-time ACS, recurrent events were common (20.8%). Increasing NT-proBNP levels and Māori ethnicity were predictors of death/cardiovascular readmission, but not after adjustment for the 20 clinical risk factors represented by the clinical summary score.
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