Abstract
Background Previously, ethnic inequalities in prognosis after a first acute myocardial infarction were observed in the Netherlands. This might be due to differences in revascularisation rate between ethnic minority groups and ethnic Dutch. Therefore, we investigated inequalities in revascularisation rate after occurrence of an ST-elevation myocardial infarction (STEMI) between first generation ethnic minority groups (henceforth, migrants) and ethnic Dutch. Methods All STEMI events between 2006 and 2011 were identified in a subset of the Achmea Health Database, which records medical care to persons insured at the Achmea health insurance company, a major health insurance company in the central part of the Netherlands. Ethnic Dutch and migrants from Suriname (Hindustani Surinamese and non-Hindustani Surinamese), Morocco, and Turkey were included (n = 1,765). Multivariable Cox proportional hazards regression analyses were used to identify ethnic inequalities in revascularisation rate (percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)) after a STEMI event. Results On average, 73.2% of STEMI events were followed by a revascularisation procedure. After adjustment for confounders (age, sex, degree of urbanization) no significant differences in revascularisation rate were found between the ethnic Dutch population and Hindustani Surinamese (HR: 1.04; 0.85–1.27), non-Hindustani Surinamese (HR: 0.98; 0.63–1.51), Moroccan (HR: 0.94; 0.77–1.14), and Turkish migrants (HR: 1.04; 0.88–1.24). Additional adjustment for comorbidity and neighborhood income did not change our findings. PLOS ONE | September 14, 2015 1 / 9 a11111 OPEN ACCESS Citation: van Oeffelen AAM, Rittersma S, Vaartjes I, Stronks K, Bots ML, Agyemang C (2015) Are There Ethnic Inequalities in Revascularisation Procedure Rate after an ST-Elevation Myocardial Infarction? PLoS ONE 10(9): e0136415. pone.0136415 Editor: Carmine Pizzi, University of Bologna, ITALY Received: February 7, 2015 Accepted: August 3, 2015 Published: September 14, 2015 Copyright: © 2015 van Oeffelen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data from the Achmea health database were linked to data from Statistics Netherlands in a secured manner. All our analyses were performed within strict privacy rules, i.e. only researchers who received a signed permit were allowed to do analyses within a secured environment at our Institute. Therefore, it is not possible to make the data underlying our findings fully available. A request for data from the Achmea Health Database can be done by filling in a request form, which can be found online via zorgaanbieders/kwaliteit-en-innovatie/paginas/