Acute myocardial infarction hospitalization and treatment: Areas with a high percentage of First Nations identity residents.

BACKGROUND: Deaths from acute myocardial infarction (AMI) are higher among First Nations people than among non-Aboriginal Canadians. Hospital interventions often involve revascularization: percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Because patients' ethnicity is not reported consistently in hospital records, no national information is available about AMI hospitalizations or the use of such procedures among First Nations people. DATA AND METHODS: This study uses an area-based approach to identify AMI hospital patients who live in Dissemination Areas with relatively high percentages of First Nations residents. Within the AMI patient cohort, procedures received during the hospital admission were identified.
RESULTS: The age-standardized hospitalized AMI event rates were 276.8 per 100,000 population for residents of high-percentage First Nations identity areas and 157.1 per 100,000 population for residents of low-percentage Aboriginal identity areas. AMI patients from high-percentage First Nations identity areas were less likely than patients from low-percentage Aboriginal identity areas to undergo revascularization, a difference largely driven by a lower PCI procedure rate. The lower PCI procedure rate persisted when controlling for age, sex, rural/urban residence, and the patient's condition at admission.
INTERPRETATION: Residents of high-percentage First Nations identity areas were more likely to be hospitalized for AMI, but were less likely to undergo revascularization.