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A framework for overcoming disparities in management of acute coronary syndromes in the Australian Aboriginal and Torres Strait Islander population. A consensus statement from the National Heart Foundation of Australia


Cardiovascular disease, particularly coronary heart disease (CHD), is the major cause of premature death for Aboriginal and Torres Strait Islander peoples, accounting for 26% of all deaths.1 Cardiovascular disease is also a major contributor to the gaps in life expectancy between Indigenous and non-Indigenous Australians,2 with recent statistics suggesting that Australian Aboriginal and Torres Strait Islander men and women can expect to live 10.6 and 9.5 fewer years, respectively, than other Australians.3

Acute coronary syndromes (ACS) include a broad spectrum of clinical presentations including ST-elevation myocardial infarction (STEMI), non-STEMI and an accelerated pattern of angina without evidence of myonecrosis (unstable angina); the latter two are often grouped as non-ST-elevation acute coronary syndromes (NSTEACS). Current National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines highlight the importance of effective systems of care in delivering optimal management of ACS.46

In 2006, the Australian Institute of Health and Welfare (AIHW) released a landmark report on access to ACS treatment by Aboriginal and Torres Strait Islander patients. The report found that, compared with other Australians, Indigenous…