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

Adriana Sudzinova (), Jaroslav Rosenberger, Roy E. Stewart, Jitse P. Dijk and Sijmen A. Reijneveld
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Adriana Sudzinova: East Slovakian Institute for Cardiac and Vascular Diseases
Jaroslav Rosenberger: Safarik University
Roy E. Stewart: University of Groningen
Jitse P. Dijk: Safarik University
Sijmen A. Reijneveld: University of Groningen

International Journal of Public Health, 2016, vol. 61, issue 3, No 12, 375-382

Abstract: Abstract Objectives The 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. Methods 623 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. Results Roma 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. Conclusions Poor 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.

Keywords: Mortality; Coronary angiography; Coronary artery disease; Roma ethnicity; Self-rated health (search for similar items in EconPapers)
Date: 2016
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DOI: 10.1007/s00038-015-0771-y

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