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Effects of socioeconomic status on mortality after acute myocardial infarction.

Publication ,  Journal Article
Chang, W-C; Kaul, P; Westerhout, CM; Graham, MM; Armstrong, PW
Published in: Am J Med
January 2007

PURPOSE: To assess the effects of socioeconomic status on mortality in patients with acute myocardial infarction. MATERIAL AND METHODS: We studied a retrospective cohort of 5622 patients who presented to a hospital emergency department with an initial episode of acute myocardial infarction between April 1998 and March 2002 in the Province of Alberta, Canada. Our main outcome measure was 1-year all-cause mortality following the index emergency department visit; we used socioeconomic status (measured by neighborhood median household income) as our main predictor after controlling for patient and hospital characteristics and revascularization. RESULTS: Socioeconomic status profoundly affected the rate of emergency department presentation and the process and outcome of acute myocardial infarction care. In patients belonging to the lowest versus the highest socioeconomic status quartile, the risk of presenting to the emergency department was 72% higher (P <.001); at 1 year, revascularization was lower (36% vs 48%, P <.001), and mortality higher (19.1% vs 9.1%, P <.001). Socioeconomic status was independently associated with 1-year mortality after adjustment for baseline characteristics and 1-year revascularization, and socioeconomic status was especially influential in non-revascularized patients. CONCLUSIONS: Given the influence of socioeconomic status on mortality after acute myocardial infarction and the key role of revascularization in modulating this relationship, our study has important implications for access to and process of cardiac care.

Duke Scholars

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

January 2007

Volume

120

Issue

1

Start / End Page

33 / 39

Location

United States

Related Subject Headings

  • Socioeconomic Factors
  • Social Class
  • Retrospective Studies
  • Registries
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chang, W.-C., Kaul, P., Westerhout, C. M., Graham, M. M., & Armstrong, P. W. (2007). Effects of socioeconomic status on mortality after acute myocardial infarction. Am J Med, 120(1), 33–39. https://doi.org/10.1016/j.amjmed.2006.05.056
Chang, Wei-Ching, Padma Kaul, Cynthia M. Westerhout, Michelle M. Graham, and Paul W. Armstrong. “Effects of socioeconomic status on mortality after acute myocardial infarction.Am J Med 120, no. 1 (January 2007): 33–39. https://doi.org/10.1016/j.amjmed.2006.05.056.
Chang W-C, Kaul P, Westerhout CM, Graham MM, Armstrong PW. Effects of socioeconomic status on mortality after acute myocardial infarction. Am J Med. 2007 Jan;120(1):33–9.
Chang, Wei-Ching, et al. “Effects of socioeconomic status on mortality after acute myocardial infarction.Am J Med, vol. 120, no. 1, Jan. 2007, pp. 33–39. Pubmed, doi:10.1016/j.amjmed.2006.05.056.
Chang W-C, Kaul P, Westerhout CM, Graham MM, Armstrong PW. Effects of socioeconomic status on mortality after acute myocardial infarction. Am J Med. 2007 Jan;120(1):33–39.
Journal cover image

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

January 2007

Volume

120

Issue

1

Start / End Page

33 / 39

Location

United States

Related Subject Headings

  • Socioeconomic Factors
  • Social Class
  • Retrospective Studies
  • Registries
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Logistic Models
  • Humans