Multi-Ethnic New Zealand Study of Acute Coronary Syndromes


Cardiovascular disease, which includes heart disease and stroke, is a leading cause of death in New Zealand. There are significant differences in health outcomes between population groups in NZ, with Māori almost twice as likely to have diagnosed coronary artery disease, and 1.3 times more likely to have had a stroke.  Age-specific coronary artery disease mortality rates are 2 to 3 times higher for Māori and Pacific peoples compared with non-Māori and non–Pacific.

Heart attacks, medically now termed acute coronary syndromes, are experienced by about 20,000 New Zealanders each year. Traditional risk factors such as smoking, high blood pressure, elevated cholesterol levels and diabetes are important in contributing to the causes of heart disease but approximately 50% of the susceptibility to coronary artery disease is genetically based. We are now entering the “genomic era” where the ability to unravel what our genetic information means is now cheaper and easier. The disparity in heart health outcomes in some ethnic groups, for example Māori and Pacific peoples, the high incidence of premature heart disease, and the epidemic of obesity and diabetes, create a need for better understanding of the genetic and gene-environment interactions for people with heart disease in NZ.

MENZACS, the Multi-Ethnic New Zealand Study of Acute Coronary Syndromes, is a case-control study with the goal to gain better understanding of factors that predispose certain individuals to a high risk of developing heart disease. The study aims to understand genetic factors and gene-environment interactions that contribute to disease, outcomes and response to therapy in New Zealand’s ethnically diverse population presenting with heart attacks.

The study aims to involve 3000 patients presenting with first-time heart attacks to hospitals in NZ. The study began in July 2015 and is recruiting patients at Auckland City Hospital, Middlemore Hospital, Waikato Hospital and Christchurch Hospital. In addition, 3000 healthy controls will be recruited from primary practice. The study involves some simple questions about food, lifestyle and family history, and giving a blood sample for genetic and biomarker analysis.

Study infrastructure


The study is supported by research grants from the Heart Health Research Trust of the Heart Foundation, the Healthier Lives National Science Challenge and from The University of Auckland.



The All New Zealand Acute Coronary Syndrome – Quality Improvement register (ANZACS-QI) is a web-based hospital registry collecting data on patients experiencing heart attacks in New Zealand MENZACS is an ANZACS-QI Registry trial. Several studies, including MENZACS, are now underway in parallel to ANZACS-QI which allows for simple and cost-efficient means to conduct large scale research studies in NZ.

For more information on ANZACS-QI, please see

Maori Governance Group

MENZACS has a Māori Governance Group whose purpose is to act as kaitiaki (custodians) for Māori participating in this research. The Māori Governance Group:

·         provides governance to the research team about appropriate processes for Māori across all aspects of research

·         provides support to the named Māori co-investigator in their role within the wider research team

·         is involved in joint decision making about the project as set out by the Treaty of Waitangi

At all times the group membership will include the following members, and other committee members may be co-opted as required:

·         A representative from Ngāi Tahu

·         A Māori biomedical scientist researcher in the area of genomics, biomedical science of similar

·         A Maori psychologist and or ethicist.

·         The Māori co-investigator

·         A clinical expert from research team

The Māori Governance Group is accountable to the Te Mata Ira research group or the committee or team set-up in lieu of findings from Te Mata Ira project. The MENZACS research team provides the Māori Governance Group with quarterly reports with information that includes general progress, numbers of participants (by ethnicity), issues arising, community engagement, and up and coming activities.

Patient information sheets

Please see links to the study patient information sheet and Kaupapa Māori Research Protocols Information Sheet.


Sara Aish, MENZACS Study Coordinator, The University of Auckland. Email:

Study registration and approvals

The New Zealand Health and Disability Ethics Committee approval reference for this study is 15/NTB/59.

The study is registered with the Australian New Zealand Clinical Trials Registry ( where the summary protocol and study information can be accessed



Publications relevant to the MENZACS Study:

Earle NJ, Poppe KK, Doughty RN, Rolleston A, Kerr AJ, Legget ME. Clinical Characteristics and Burden of Risk Factors Among Patients With Early Onset Acute Coronary Syndromes: The ANZACS-QI New Zealand National Cohort (ANZACS-QI 17). Heart, Lung & Circulation 2017. doi 10.1016/j.hlc.2017.04.010