The Association of Socioeconomic Status with Three-Year Clinical Outcomes in Patients with Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention

Abstract

The aim of this study was to evaluate whether the clinical outcomes were associated with socioeconomic status (SES) in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI). The author analyzed 2,358 patients (64.9 ± 12.3 yr old, 71.5% male) hospitalized with AMI between November 2005 and June 2010. SES was measured by the self-reported education (years of schooling), the residential address (social deprivation index), and the national health insurance status (medical aid beneficiaries). Sequential multivariable modeling assessed the relationship of SES factors with 3-yr major adverse cardiovascular events (MACEs) and mortality after the adjustment for demographic and clinical factors. During the 3-yr follow-up, 630 (26.7%) MACEs and 322 (13.7%) all-cause deaths occurred in 2,358 patients. In multivariate Cox proportional hazards regression modeling, the only lower education of SES variables was associated with MACEs (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.04-1.91) and mortality (HR, 1.93; 95% CI, 1.16-3.20) in the patients with AMI who underwent PCI. The study results indicate that the lower education is a significant associated factor to increased poor clinical outcomes in patients with AMI who underwent PCI.Graphical Abstract

Selected Food Consumption Mediates the Association between Education Level and Metabolic Syndrome in Korean Adults

“…The association was significant in women but not in men, consistent with previous results from the KHANES [30,31]. Similarly, low education level was associated with higher mortality of CVD [11], clinical outcome of myocardial infarction [12,] and stroke [13]. Interestingly, different impacts of SES, particularly low education level on cardiovascular risks, such as DM [14], HTN [15,16], and dyslipidemia [17] in a gender-dependent manner have also been reported in Korean adults.…”

“…They also concluded that higher education may be the best SES predictor of good health. However, emerging evidence has inconsistently reported that low SES including education level is related to poor health outcome including CVD, stroke, T2DM, HTN, and dyslipidemia [11,12,13,14,15,16,17] particularly in Korean population. Several behavioral measures have linked SES to cardiovascular health, include smoking, alcohol behavior, physical activity, and diet [18].…”

Social Determinants of Myocardial Infarction Risk and Survival: A Systematic Review

“…When comparing the most deprived neighbourhood-level socioeconomic quintile with the most affluent quintile, the overall relative risk for acute myocardial infarction was 1.34 (95% CI 1.32, 1.36) in men and 1.44 (95% CI 1.42, 1.47) in women. Kim et al conducted a retrospective cohort study of acute myocardial infarction patients as one referral center in South Korea [ 27 ]. No significant association was seen between a neighborhood socioeconomic status indicator (social deprivation index) and mortality.…”

The excess long-term mortality in peptic ulcer bleeding is explained by nonspecific comorbidity

“…Previous studies have shown that poor socioeconomic status increases the risk of being infected with H. pylori [18] and also increases the long-term mortality in some diseases [16,17]. Based on this, poor socioeconomic status could play an important role in long-term mortality in PUB.…”

“…Poor socioeconomic status seems to be associated with a considerable increase in long-term mortality following percutaneous coronary intervention in patients with acute myocardial infarction [16] and increased mortality following elective colorectal surgery [17]. Socioeconomic factors may also play an important role in PUB as poor socioeconomic status increases the risk of an infection with Helicobacter pylori with more than a twofold [18].…”