379 Incidence of acute coronary syndrome by ethnicity in New South Wales, Australia: a census-linked cohort study

Abstract OP 33: Diseases and Interventions 1, B304 (FCSH), September 5, 2025, 09:00 - 10:00 Aims Coronary artery disease remains a leading cause of morbidity and mortality in Australia, with acute coronary syndrome (ACS) being its most critical manifestation. However, little is known about the burden of ACS across different ethnic groups within the non-Indigenous Australian population. This study aimed to characterise the age-standardised incidence of ACS by ethnicity in New South Wales (NSW). Methods We conducted a population-based cohort study of NSW residents aged 25 years and older who responded to the 2016 Census and were successfully linked to the Person Linked Data Asset (PLIDA) (n = 4,609,869). We excluded those with a past history of ACS based on hospital data in the previous 10 years. Incident cases of ACS were identified from hospital and deaths data based on ICD-10 codes. Follow up was from July 1, 2016 to June 30, 2022. Ethnicity was based on self-reported ancestry in the Census, with categorisations informed by an expert and community panel. Results In preliminary results, the age-standardised incidence rate of ACS was 167 per 100,000 in females and 322 per 100,000 in males. The highest risk of ACS was observed in Pasifika and Māori populations, with Pasifika males experiencing the greatest overall incidence (619 per 100,000) and Māori females having the highest incidence among women (301 per 100,000). Increased ACS risk was also observed in North African and Middle Eastern, Southern, and Central Asian ethnic groups. In contrast, East Asian, South American, North American and Southern and East African ethnic groups exhibited lower ACS incidence compared to the population average. Conclusions Our findings reveal significant ethnic disparities in ACS incidence, particularly among Māori and Pasifika populations, which have been poorly characterised in prior Australian research. These results underscore the urgent need for targeted public health strategies to address the underlying drivers of these inequalities.