Aboriginal and Torres Strait Islander people experience acute coronary syndrome (ACS) at younger ages and with higher lifetime prevalence than non-Indigenous Australians. Standard ED chest pain assessments focus on short-term risk of ACS, identifying patients who may require immediate intervention such as those with acute myocardial infarction. However, this approach may not identify all patients with underlying coronary artery disease (CAD), leaving some at risk of future cardiac events.
“Research in this area of medicine is so important to the people of far North Queensland who clearly bear a large burden of cardiovascular disease,” explained Dr Katrina Starmer.
Supported by EMF funding, Dr Starmer and her colleagues at Cairns Hospital and the RBWH examined how common CAD is among First Nations patients presenting with chest pain. Of 160 participants, 140 underwent detailed heart scans: 49 received computed tomography coronary angiography (CTCA) and 99 had invasive coronary angiography (ICA). Over 60% showed clinically significant narrowing in at least one coronary artery, strongly associated with hypertension, diabetes, and dyslipidaemia.
The research enabled earlier diagnosis and treatment for many participants, potentially preventing heart attacks and other serious events.
Next StepsThe findings have already influenced practice and policy, and CTCA testing continues at Cairns Hospital for Aboriginal and Torres Strait Islander patients with suspected ACS.
This research also informed a successful MRFF grant, the Powerful Pictures Study, led by Prof Louise Cullen at Queensland University of Technology’s Australian Centre for Health Services Innovation (AusHSI), Prof Cullen shared,
“The EMF grant enabled our team to define a good understanding of the scale of the problem, providing essential data that supported the successful MRFF grant application.”
This larger study places First Nations partners, communities, patients and clinicians at the centre to co-design better models of care, now being implemented across Cairns, Atherton and Weipa hospitals.
This work aligns with updated National Heart Foundation guidelines, which recommend CTCA for most intermediate-risk patients with suspected ACS. It also supports broader cardiovascular risk screening for First Nations people aged 18 and over. Together, these findings show how targeted ED imaging can reduce future cardiac events while building sustainable research capability in Far North Queensland.
By enabling earlier detection and therefore treatment of CAD, this research is helping to change the trajectory of heart disease for Aboriginal and Torres Strait Islander patients and sets out a model for culturally informed, evidence-based care across the region.
“This body of research is helping to establish guidelines relevant to First Nations Australians by listening to their voices and observing outcomes from actual First Nations cohorts, rather than relying on data from non-Indigenous populations which was all that has been historically available to date. This contributes significantly towards closing the gap in care for emergency and cardiological conditions for First Nations Australians,” outlines Dr Starmer