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.
Keywords
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Article Info
Publication History
Published online: September 04, 2018
Accepted:
August 4,
2018
Received in revised form:
May 14,
2018
Received:
September 1,
2017
Identification
Copyright
© 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).
