Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the
Helena Tizón-Marcos1,2,3,4, Beatriz Vaquerizo1,2,3,4,5, Josepa Mauri Ferré6,7
1Hospital del Mar, Servicio de Cardiología, Barcelona, Spain.
Insights
Socioeconomic status (SES) did not impact 30-day or 1-year outcomes for ST-elevation myocardial infarction (STEMI) patients in Barcelona. Despite younger age and worse clinical profiles, low-SES patients had comparable mortality and cardiovascular events.
Area of Science:
- Cardiology
- Public Health
- Health Economics
Background:
- Healthcare access inequalities negatively affect cardiovascular prognosis.
- Socioeconomic status (SES) is a key determinant of health outcomes.
- ST-elevation myocardial infarction (STEMI) networks aim to reduce disparities in emergency cardiac care.
Purpose of the Study:
- To evaluate the impact of SES on mortality and complications in STEMI patients.
- To assess disparities in cardiovascular outcomes based on the Family Income Ratio of Barcelona (FIRB).
- To analyze the effectiveness of the "Codi IAM" network in mitigating SES-related inequalities.
Main Methods:
- A cohort study of 3,322 STEMI patients treated in Barcelona (2010-2016).
- Patients were stratified into three SES groups using the FIRB score.
- Logistic regression analysis was used to determine the association between SES and mortality/cardiovascular events.
Main Results:
- Low-SES patients were younger, more often hypertensive, diabetic, and dyslipidemic.
- Patients with low SES experienced longer reperfusion delays.
- Low SES was not independently associated with 30-day mortality, 30-day composite cardiovascular endpoint, or 1-year all-cause mortality.
Conclusions:
- Despite worse clinical profiles and longer delays, low-SES STEMI patients in Barcelona had comparable 30-day and 1-year outcomes to higher-SES patients.
- The "Codi IAM" network may be mitigating the negative impact of SES on STEMI patient outcomes.
- Further research is needed to confirm these findings and explore the mechanisms behind outcome comparability.
Background:
Despite the spread of ST-elevation myocardial infarction (STEMI) emergency intervention networks, inequalities in healthcare access still have a negative impact on cardiovascular prognosis. The Family Income Ratio of Barcelona (FIRB) is a socioeconomic status (SES) indicator that is annually calculated. Our aim was to evaluate whether SES had an effect on mortality and complications in patients managed by the "Codi IAM" network in Barcelona.
Methods:
This is a cohort study with 3,322 consecutive patients with STEMI treated in Barcelona from 2010 to 2016. Collected data include treatment delays, clinical and risk factor characteristics, and SES. The patients were assigned to three SES groups according to FIRB score. A logistic regression analysis was conducted to estimate the adjusted effect of SES on 30-day mortality, 30-day composite cardiovascular end point, and 1-year mortality.
Results:
The mean age of the patients was 65 ± 13% years, 25% were women, and 21% had diabetes mellitus. Patients with low SES were younger, more often hypertensive, diabetic, dyslipidemic (p < 0.003), had longer reperfusion delays (p < 0.03) compared to participants with higher SES. Low SES was not independently associated with 30-day mortality (OR: 0.95;9 5% CI: 0.7-1.3), 30-day cardiovascular composite end point (OR: 1.03; 95% CI: 0.84-1.26), or 1-year all-cause mortality (HR: 1.09; 95% CI: 0.76-1.56).
Conclusion:
Although the low-SES patients with STEMI in Barcelona city were younger, had worse clinical profiles, and had longer revascularization delays, their 30-day and 1-year outcomes were comparable to those of the higher-SES patients.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:26Acute Coronary Syndrome V: Nursing Management
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care