Acute Coronary Syndrome Incidence, Procedures, and Mortality Outcomes in New Zealand 2006–2016: ANZACS-QI 27 Nationwide Data Linkage Study

Abstract

Background: Cardiovascular disease is the leading global cause of death; although patterns may differ around the world. Evaluating trends in acute coronary syndrome (ACS) incidence and treatment – including coronary angiography, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) – and outcomes inform the evolving disease burden and management. This national data-linkage study reported ACS trends in New Zealand during 2006–2016. Methods: All adult ACS hospitalisations in New Zealand from 2006–2016 were identified via ICD-10 coding, and demographics, coronary procedures, and mortality (at 28 days and 1 year) obtained by national dataset linkage, to evaluate ACS trends by calendar year. Results: There were 188,264 ACS admissions from 2006–2016, with a steady decline from 685 to 424/100,000/year in 2006 and 2016, respectively. There was a significant increase in coronary angiography rates from 29.8% to 54.3%, and total revascularisation rates from 20.6% to 37.3%, respectively. Women with ACS admissions were older than men, and had lower coronary procedural rates. Corresponding figures for PCI rates were 16% to 31%, and were more blunted for CABG at 4.6% to 6.5%. Both 28-day and 1-year mortality slightly reduced from 2006–2016 at 10.1% to 8.9% and 22.1% to 19.0%, respectively; this was similar for both sexes and higher with older age groups. Conclusions: The ACS incidence rates in New Zealand decreased from 2006-2016, while coronary angiography and total revascularisation rates increased, although to a much greater extent for PCI than CABG. Mortality rates also decreased over time and were similar for both sexes despite lower procedural rates in females.