(P018) ACUTE CORONARY SYNDROMES IN INDIGENOUS AND NON-INDIGENOUS FEMALES: A NORTHERN SASKATCHEWAN DECRIPTION OF PRESENTATION AND OUTCOMES

Background: How health inequities disproportionately experienced by Indigenous compared with non-Indigenous women, associate with all-cause mortality following an acute coronary syndrome (ACS), remains limited.

METHODS AND RESULTS: Women (self identified as Indigenous or non-Indigenous) hospitalized with STEMI or NSTEMI/UA from March 2019 to December 2022 in Saskatoon, Saskatchewan were included. We compared differences in demographics, treatment, and all-cause mortality (in-hospital and over 3-years). Cox regression models were used to estimate the adjusted hazard risk (aHR, 95% confidence interval) for all-cause mortality.

Of 3,946 ACS hospitalizations, 1,212 were female: STEMI (n=394, Indigenous 16.8%) and NSTEMI/UA (n= 818, Indigenous 14.5%). Across STEMI and NSTEMI/UA, Indigenous compared with non-Indigenous women were significantly younger, with higher proportions of diabetes and cigarette smoking; for NSTEMI/UA specifically, Indigenous women were also more likely to present with cardiogenic shock/arrest, have multivessel coronary disease, and cerebrovascular or peripheral arterial disease. Respective in-hospital and adjusted 3-year mortality risk for Indigenous and non-Indigenous women was: STEMI 12.1% vs. 9.4%, p=0.51; aHR 1.13, 95% CI: 0.51, 2.50, p=0.76; NSTEMI 4.2% vs. 1.9%, p=0.16; aHR 2.31, 95% CI: 1.26, 4.25, p=0.007.

Conclusion: Nearly one in six women hospitalized with ACS was Indigenous, and in whom despite their younger age - had higher comorbidity, atherosclerotic burden, presentation acuity - and associated with higher adjusted mortality following NSTEMI/UA. Culturally aligned strategies addressing women-specific primary and secondary cardiovascular risks, and differentially for reproductive and menopausal years, are needed to bridge the disparate health outcomes, particularly so, for Indigenous women presenting with an ACS.