Evidence map›Paper›PMID 33139389›Full record

ArticleCMAJ open

Differences in coronary artery disease complexity and associations with mortality and hospital admissions among First Nations and non-First Nations patients undergoing angiography: a comparative retrospective matched cohort study.

Annette Schultz, Lindsey Dahl, Elizabeth McGibbon, Jarvis Brownlie, Catherine Cook, Basem Elbarouni, Alan Katz, Thang Nguyen, Jo-Ann V Sawatzky, Heather J Prior and 3 more

Open access · diamondAbstract readComparative Study
PubMed Full text at PMC Publisher
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Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 1 country.

Annette SchultzCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. annette.schultz@umanitoba.ca.
Lindsey DahlCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Elizabeth McGibbonCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Jarvis BrownlieCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Catherine CookCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Basem ElbarouniCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Alan KatzCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Thang NguyenCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Jo-Ann V SawatzkyCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Heather J PriorCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Moneca SinclaireCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Karen ThrondsonCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
Randy FransooCollege of Nursing (Schultz, Dahl, Sawatzky, Sinclaire), Rady Faculty of Health Sciences, University of Manitoba; St. Boniface Hospital Research Centre (Schultz, Dahl, Sawatzky, Sinclaire), Winnipeg, Man.; Rankin School of Nursing, Faculty of Health Sciences (McGibbon), St. Francis Xavier University, Antigonish, NS; Department of History (Brownlie), Faculty of Arts, University of Manitoba; First Nations, Métis and Inuit Health (Cook), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba; Cardiac Sciences Program, St. Boniface Hospital (Elbarouni, Nguyen, Throndson); Max Rady College of Medicine (Elbarouni, Nguyen), Rady Faculty of Health Sciences, University of Manitoba; Manitoba Centre for Health Policy (Katz, Fransoo, Prior), and Max Rady College of Medicine (Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.
St. Boniface Hospital · CAUniversity of Manitoba · CASt. Francis Xavier University · CAFirst Nations Health and Social Secretariat of Manitoba · CA

Funding

CIHR MOP-136904
6 · The paper itself

Abstract

backgroundFirst Nations people are more likely than the general population to experience long-term adverse health outcomes after coronary angiography. Our aim was to quantify the extent of coronary artery disease among First Nations and non-First Nations patients undergoing angiography to investigate differences in coronary artery disease and related health disparities.

methodsWe conducted a retrospective matched cohort study to compare health outcomes of First Nations and non-First Nations adult patients (> 18 yr) who underwent index angiography between Apr. 1, 2008, and Mar. 31, 2012, in Manitoba, Canada. The SYNTAX Score was used to measure and compare severity of coronary artery disease between groups. Primary outcomes of all-cause and cardiovascular mortality were compared between groups using Cox proportional hazard models adjusted by SYNTAX Score results and weighted by the inverse probability of being First Nations. Secondary outcomes included all-cause and cardiovascular-related hospital admissions.

resultsThe cohort consisted of 277 matched pairs of First Nations and non-First Nations patients undergoing angiography; the average age of patients was 56.0 (standard deviation 11.7) years. The median SYNTAX Score results and patient distributions across categories in the matched paired cohort groups were not significantly different. Although proportionally First Nations patients showed worse health outcomes, mortality risks were similar in the weighted sample, even after controlling for revascularization and SYNTAX Score results. Secondary outcomes showed that adjusted risks for hospital admission for acute myocardial infarction (adjusted hazard ratio [HR] 3.03, 95% confidence interval [CI] 1.40-6.55) and for congestive heart failure (adjusted HR 3.84, 95% CI 1.37-10.78) were significantly higher among First Nations patients in the weighted sample.

interpretationThe extent of coronary artery disease among matched cohort groups of First Nations and non-First Nations patients appears similar, and controlling for baseline sociodemographic characteristics, coronary artery disease risk factors and SYNTAX Score results explained higher mortality risk and most hospital admissions among First Nations patients. Although there is a need to decrease risk factors for coronary artery disease among First Nations populations, addressing individuals' behaviour without considering root causes underlying risk factors for coronary artery disease will fail to decrease health outcome disparities among First Nations patients undergoing angiography.

Indexed as

AdultAgedCause of DeathCoronary AngiographyCoronary Artery DiseaseFemaleHealthcare DisparitiesHeart FailureHospitalizationHumansIndigenous PeoplesMaleManitobaMiddle AgedMortalityMyocardial Infarction

Identifiers

PMID33139389
PMCPMC7608944
OpenAlexW3095698404

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.