J Korean Med Sci.  2014 Apr;29(4):536-543. 10.3346/jkms.2014.29.4.536.

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

• Kim JH
• Jeong MH
• Park IH
• Choi JS
• Rhee JA
• Lee DH
• Park SH
• Kim IS
• Jeong HC
• Cho JY
• Jang SY
• Lee KH
• Park KH
• Sim DS
• Kim KH
• Hong YJ
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC

• KMID: 1774459
• DOI: http://doi.org/10.3346/jkms.2014.29.4.536

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.

Keyword

Social Class; Acute Myocardial Infarction; Mortality

MeSH Terms

Acute Disease
Age Factors
Aged
*Angioplasty, Balloon, Coronary
Cohort Studies
Demography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction/economics/mortality/*therapy
*Percutaneous Coronary Intervention
Proportional Hazards Models
Retrospective Studies
Risk Factors
Sex Factors
Social Class
Socioeconomic Factors
Treatment Outcome

Figure

• 

  Fig. 1 Unadjusted Kaplan-Meier curve. (A) Three-year major adverse cardiovascular events (MACEs) and (B) three-year mortality are significantly different according to the level of education (Log-rank test, P < 0.001).

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