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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?

  • Original Article
  • Published:
International Journal of Public Health

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.

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Acknowledgments

This work was supported by a grant from the Slovak Society of Cardiology, year 2005, and by the Slovak Research and Development Agency under contract No. APVV-0220-10 (80 %). Furthermore, this work was supported by the Agency of the Slovak Ministry of the Education, Science, Research and Sport of the Slovak Republic for the Structural Funds of the EU under project No. ITMS: 26220120058 (20 %). The authors would like to thank Helena Vargová, Daniela Ondušová, Zuzana Škodová, Barbora Šilárová, Diana Matláková and Cecília Bukátová for their substantial support in the data collection.

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Authors and Affiliations

  1. Cardiology Clinic, East Slovakian Institute for Cardiac and Vascular Diseases, Ondavska 8, 040 01, Kosice, Slovak Republic

    Adriana Sudzinova

  2. Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic

    Adriana Sudzinova, Jaroslav Rosenberger & Jitse P. van Dijk

  3. Department of Community and Occupational Health, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands

    Roy E. Stewart, Jitse P. van Dijk & Sijmen A. Reijneveld

Authors
  1. Adriana Sudzinova
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  2. Jaroslav Rosenberger
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  3. Roy E. Stewart
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  4. Jitse P. van Dijk
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  5. Sijmen A. Reijneveld
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Correspondence to Adriana Sudzinova.

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Sudzinova, A., Rosenberger, J., Stewart, R.E. et al. Does poorer self-rated health mediate the effect of Roma ethnicity on mortality in patients with coronary artery disease after coronaro-angiography?. Int J Public Health 61, 375–382 (2016). https://doi.org/10.1007/s00038-015-0771-y

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  • DOI: https://doi.org/10.1007/s00038-015-0771-y

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