Abstract
Background: Each year approximately 5,000 New Zealanders are admitted to hospital with a first-time acute coronary syndrome (ACS). The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) study aims to examine the relationship of clinical, genomic and cardiometabolic markers in relation to presentation and outcomes post-ACS.
Method: MENZACS is a prospective, longitudinal registry-based study embedded within the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) programme in 6 hospitals. Patients with first-time ACS were enrolled and additional study-specific data collected. Blood samples were stored for genetic/biomarker assays. We report here the first outcome data for MENZACS.
Results: Between 2015-2019, 2,015 patients were enrolled, mean age 61 yrs, 21% female, 13% Māori, 5% Pacific, and 74% European. Over a median of 2.4 years of follow-up, 422 (21%) patients either died or were readmitted to hospital for cardiovascular cause. Event rates were similar for those with STEMI and NSTEMI (20.9%, 21.0% respectively). In a Cox proportional hazards model including age, sex, ethnicity and N-terminal proB-type natriuretic peptide (NTproBNP), the independent predictors of death/cardiovascular readmission were female sex (hazard ratio [HR]=1.30;95%CI: 1.03,1.63), age per 10yrs (HR=1.18, 95%CI:1.09,1.28), Māori ethnicity (HR=1.46;95%CI:1.10,1.93) and increasing NTproBNP (HR=1.12;95%CI: 1.04,1.20).
Conclusion: MENZACS represents patients with first-time ACS who received optimal contemporary management. One in five patients died or were readmitted to hospital for a cardiovascular cause within 2.4yrs of their index ACS event. Further understanding of the predictors of recurrent events will be enhanced by the cardiometabolic and genomic markers being measured in the MENZACS cohort.