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English as a second language and outcomes of patients presenting with acute coronary syndromes: results from the CONCORDANCE registry

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Australia is one of the most culturally and linguistically diverse nations in the world, its population of 24 million including an estimated 6 million people who were born overseas.1 Australian research has shown a higher prevalence of cardiovascular risk factors among southern European, Middle Eastern and Indian immigrants.2,3 The lack of a mutually comprehensible and usable written and spoken language is a major barrier to effective communication between health care providers and patients. This potentially affects the provision of primary and secondary disease preventive care, which, in turn, may affect patient outcomes. Immigrants from non-English-speaking backgrounds have a higher incidence of admissions for acute myocardial infarction, and remain in hospital longer than their English-speaking peers.4 Communication and language barriers have also been shown to affect the provision of quality care for South Asian immigrants.5

The Cooperative National Registry of Acute Coronary Care, Guideline Adherence and Clinical Events (CONCORDANCE) is an Australian observational registry that describes the management and outcomes of patients presenting to hospitals with acute coronary syndromes (ACS) from geographically diverse regions of Australia.6