English as a second language and outcomes of patients presenting with acute coronary syndromes: results from the CONCORDANCE registry

Objectives: To investigate whether patients with English as their second language have similar acute coronary syndrome (ACS) outcomes to people whose first language is English. Design: Retrospective, observational study, using admissions, treatment and follow‐up data. Participants and setting: : A total of 6304 subjects from 41 sites enrolled in the investigator‐initiated CONCORDANCE ACS registry. Main outcome measures: Baseline characteristics, treatments, and in‐hospital and 6‐month mortality. Results: English as a second language (ESL) was reported by 1005 subjects (15.9%). Patients with English as their first language (EFL) were older, and were less likely to have diabetes mellitus or to smoke than the ESL patients. Prior myocardial infarction, heart failure and chronic renal failure were more common in the ESL group. In‐hospital mortality was also higher in these patients (7.1% v 3.8% for EFL patients; P