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Does poorer self-rated health mediate the effect of Roma ethnicity on mortality in patients with coronary artery disease after coronaro-angiography?

Authors
  • Sudzinova, Adriana1, 2
  • Rosenberger, Jaroslav2
  • Stewart, Roy E.3
  • van Dijk, Jitse P.2, 3
  • Reijneveld, Sijmen A.3
  • 1 East Slovakian Institute for Cardiac and Vascular Diseases, Cardiology Clinic, Ondavska 8, Kosice, 040 01, Slovak Republic , Kosice (Slovakia)
  • 2 Safarik University, Graduate School Kosice Institute for Society and Health, Kosice, Slovak Republic , Kosice (Slovakia)
  • 3 University of Groningen, Department of Community and Occupational Health, University Medical Centre Groningen, Groningen, The Netherlands , Groningen (Netherlands)
Type
Published Article
Journal
International Journal of Public Health
Publisher
Springer International Publishing
Publication Date
Dec 12, 2015
Volume
61
Issue
3
Pages
375–382
Identifiers
DOI: 10.1007/s00038-015-0771-y
Source
Springer Nature
Keywords
License
Yellow

Abstract

ObjectivesThe aim of this prospective cohort study was to assess the effect of Roma ethnicity and self-rated health (SRH) on 9-year all-cause mortality in patients with coronary artery disease (CAD) after coronaro-angiography (CAG), and whether SRH mediates the effect of ethnicity.Methods623 patients (103 Roma) were included. We obtained data from medical records and patients interviews. A Cox regression model adjusted for age, gender and education was used to analyze the effect of Roma ethnicity on mortality, as well as potential mediation by SRH.ResultsRoma ethnicity and poor SRH were predictors of increased mortality in patients with CAD, with hazard rates (95 % confidence intervals) 2.34 (1.24; 4.42) and 1.81 (1.02; 3.21). Adding education decreased the size of ethnic differences in mortality. The mediating effect of SRH on the association of ethnicity with mortality was not statistically significant; neither modified ethnicity the effect of SRH.ConclusionsPoor SRH does not mediate the higher mortality among Roma patients after CAG even though it indicates an increased risk of mortality. Roma patients with CAD have to be referred for special cardiological care earlier.

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