High long-term mortality in ischaemic heart disease accentuated among ethnic minorities in Eastern Europe: findings from a prospective all-comers percutaneous coronary intervention registry in Romania

Paul-Adrian Călburean; Paul Grebenișan; Ioana-Andreea Nistor; Ioana Paula Șulea; Anda-Cristina Scurtu; Klara Brinzaniuc; Horatiu Suciu; Marius Harpa; Dan Dobreanu; Laszlo Hadadi

doi:10.1136/jech-2024-222845

High long-term mortality in ischaemic heart disease accentuated among ethnic minorities in Eastern Europe: findings from a prospective all-comers percutaneous coronary intervention registry in Romania

J Epidemiol Community Health. 2024 Nov 12:jech-2024-222845. doi: 10.1136/jech-2024-222845. Online ahead of print.

Authors

Paul-Adrian Călburean^{1

2}, Paul Grebenișan², Ioana-Andreea Nistor², Ioana Paula Șulea³, Anda-Cristina Scurtu^{3

2}, Klara Brinzaniuc^{3

2}, Horatiu Suciu^{3

2}, Marius Harpa^{3

2}, Dan Dobreanu^{3

2}, Laszlo Hadadi²

Affiliations

¹ George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania paul.calburean@umfst.ro.
² Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Targu Mures, Romania.
³ George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania.

PMID: 39532395
DOI: 10.1136/jech-2024-222845

Abstract

Background: Long-term outcomes in cardiovascular diseases are historically under-reported in Eastern Europe. Our aim was to report long-term survival and to identify survival predictors in a prospective Romanian percutaneous coronary intervention (PCI) registry, with an emphasis on important under-resourced minorities, such as Hungarian and Roma ethnicities.

Methods: An all-comers patient population treated by PCI in a tertiary cardiovascular centre that has been included prospectively in the local registry since January 2016 was analysed. Cardiovascular cause and all-cause mortality data were available as of December 2023.

Results: A total of 6867 patients with 8442 PCI procedures were included. Romanian group consisted of 5095 (74.2%) patients, the Hungarian group consisted of 1417 (20.6%) patients and the Roma group consisted of 355 (5.1%) patients. During a median follow-up of 3.60 (1.35-5.75) years, a total of 1064 cardiovascular-cause and 1374 all-cause events occurred. Romanian, Hungarian and Roma patients suffered 5.12, 5.89 and 7.71 all-cause deaths per 100 patient-years, respectively. Romanian, Hungarian and Roma patients suffered 3.94, 4.63 and 6.22 cardiovascular-cause deaths per 100 patient-years, respectively. Both Hungarian and Roma patients presented significantly higher all-cause mortality than Romanian patients (adjusted HR (aHR)=1.20 (1.05-1.36), p=0.005 and aHR=1.51 (1.21-1.88), p=0.0001). Similarly, Hungarian and Roma patients presented significantly higher cardiovascular cause mortality than Romanian patients (aHR=1.22 (1.05-1.41), p=0.006 and aHR=1.51 (1.18-1.92), p=0.0008).

Conclusions: High long-term cardiovascular and all-cause mortality was observed for the entire included population. Long-term survival was significantly lower in ethnic minorities, such as the Hungarian and Roma minority than in the Romanian population.

Keywords: CARDIOVASCULAR DISEASES; EPIDEMIOLOGY; ETHNIC GROUPS.