Clinical Utility of Stress Echocardiography in Remote Indigenous and Non-Indigenous Populations: A 10-Year Study in Central Australia

التفاصيل البيبلوغرافية
العنوان: Clinical Utility of Stress Echocardiography in Remote Indigenous and Non-Indigenous Populations: A 10-Year Study in Central Australia
المؤلفون: Bernhard Kuepper, Seshika Ratwatte, Wendy Corkill, Amrina Kaur, Nadarajah Kangaharan, Katrina Bolton, Bradley M. Pitman, Benedict T. Costello, Prashanthan Sanders, Christopher X. Wong
المصدر: Heart, Lung and Circulation. 29:1808-1814
بيانات النشر: Elsevier BV, 2020.
سنة النشر: 2020
مصطلحات موضوعية: Male, Rural Population, Pulmonary and Respiratory Medicine, Native Hawaiian or Other Pacific Islander, Time Factors, Population, Disease, Population health, 030204 cardiovascular system & hematology, Lower risk, Indigenous, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Stress Echocardiography, Humans, Medicine, 030212 general & internal medicine, education, Retrospective Studies, education.field_of_study, Univariate analysis, business.industry, Australia, Reproducibility of Results, Retrospective cohort study, Middle Aged, Cardiovascular Diseases, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Stress, Follow-Up Studies, Demography
الوصف: Remote Central Australia has a large Indigenous population and a significant burden of cardiovascular disease. Stress echocardiography has been previously validated as a useful investigation for long-term prognostication. However, there are no prior studies assessing its utility in remote or Indigenous populations.Consecutive individuals undergoing stress echocardiography in Central Australia between 2007 and 2017 were included. Stress echocardiography was performed and reported via standard protocols. Individuals were followed up for all-cause mortality.One-thousand and eight patients (1,008) (54% Indigenous Australian) were included. After a mean follow-up of 3.5±2.4 years, 54 (5%) patients were deceased. Overall, 797 (79%) patients had no abnormalities during rest or stress echocardiography, with no difference according to ethnicity (p0.05). In patients with a normal test, annual mortality averaged 1.3% over 5 years of follow-up, with annual mortality significantly higher in Indigenous compared to non-Indigenous individuals (1.8% vs 0.6% respectively). In those with an abnormal test, annual mortality was 4.4% vs 1.3% in Indigenous and non-Indigenous individuals respectively. Increasing age, Indigenous ethnicity and cardiometabolic comorbidities were associated with mortality in univariate analyses (p0.05 for all). In multivariate models, only chronic kidney disease remained predictive of mortality, with other associations (including Indigenous ethnicity) becoming attenuated.This is the first study to report on the use of stress echocardiography in a remote or Indigenous population. A normal stress echocardiogram in remote Indigenous individuals was able to identify a lower risk group of patients in this setting. Although Indigenous individuals with a normal test still had a higher annual rate of mortality compared to non-Indigenous individuals, this association appeared to be mediated by cardiometabolic comorbidities.
تدمد: 1443-9506
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cab2c0bd77c32b3187751a9bd8c4ba2d
https://doi.org/10.1016/j.hlc.2020.04.013
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....cab2c0bd77c32b3187751a9bd8c4ba2d
قاعدة البيانات: OpenAIRE