What is the clinical evidence from this study?

Study design: Cohort. Population: Acute coronary syndrome (n=68902). Intervention: Aboriginal status vs. Non-Aboriginal status. Primary outcome: ACS incidence and case fatality (RR 1.2-1.5).

What question did this study set out to answer?

To evaluate temporal changes in acute coronary syndrome incidence and case fatality disparities between Aboriginal and non-Aboriginal populations within the context of national Closing the Gap initiatives.

February 25, 2026Circulation Population Health and Outcomes

Temporal Trends in Acute Coronary Syndrome Incidence in Aboriginal and Non-Aboriginal People in Western Australia

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Key result

ACS incidence declines among Aboriginal people but disparities with non-Aboriginal people persist.

RR 1.2-1.5
n=68,902

Key Points

To evaluate temporal changes in acute coronary syndrome incidence and case fatality disparities between Aboriginal and non-Aboriginal populations within the context of national Closing the Gap initiatives.
Conducted a population-based cohort study linking Western Australian hospital and mortality records from 2003 to 2020 for residents aged 25 to 84 years, utilizing a fixed 18-year lookback period to establish incident acute coronary syndrome cases.
Calculated age-standardized incidence rates using prevalence-adjusted denominators and direct standardization, evaluating average annual percentage changes across pre- (2003–2008) and post-policy implementation periods (2009–2016 and 2017–2020) via Poisson regression.
Identified 4,097 Aboriginal cases (mean age: 52.3 years, 40.8% women) and 64,805 non-Aboriginal cases (mean age: 65.1 years, 31.3% women), with higher prevalence of diabetes (58.5% vs. 26.4%) and chronic kidney disease (27.5% vs. 10.9%) among Aboriginal patients.
Incidence rates declined significantly from 2009 to 2016 only among older Aboriginal men (-4.9% per year [95% CI, -8.9% to -0.7%]) and younger Aboriginal women (-4.8% per year [95% CI, -8.7% to -0.7%]).
Incidence rate ratios remained largely unchanged between 2003–2008 and 2017–2020 across cohorts (men 25–54 years: 5.2 to 5.6; women 25–54 years: 10.3 to 10.0), while case fatality remained 20% to 50% higher among Aboriginal individuals across strata (risk ratios, 1.2–1.5).

Study Design

Type

Cohort (n=68,902)

Structured PICO

Population

68,902 incident ACS cases among Western Australian residents aged 25 to 84 years between 2003 and 2020, comparing Aboriginal and non-Aboriginal populations.

Comparator

Non-Aboriginal population

Outcome

Temporal changes in ACS incidence and case fatalityhard clinical

Main Result

Effect estimate: RR 1.2-1.5

Despite some declines in ACS incidence, significant disparities in ACS incidence and case fatality persist between Aboriginal and non-Aboriginal populations in Western Australia.

Discussion

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Implication

Persistent ACS disparities persist in Aboriginal Western Australians; leaves open effective equity strategies.

Cite This Study

Ahmed et al. (2026) conducted a cohort in Acute coronary syndrome (n=68,902). Aboriginal status vs. Non-Aboriginal status was evaluated on ACS incidence and case fatality (RR 1.2-1.5). Aboriginal Australians experienced persistently higher ACS incidence and 20% to 50% higher case fatality (risk ratios 1.2-1.5) compared to non-Aboriginal people between 2003 and 2020.

synapsesocial.com/papers/699e918df5123be5ed04f2fe https://doi.org/10.1161/circoutcomes.125.012650

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Temporal Trends in Acute Coronary Syndrome Incidence in Aboriginal and Non-Aboriginal People in Western Australia

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Temporal Trends in Acute Coronary Syndrome Incidence in Aboriginal and Non-Aboriginal People in Western Australia

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider