Abstract P155: Low Socioeconomic Status Relates to Short-term Mortality Risk After Acute Myocardial Infarction, Especially in Men: Results From a Nationwide Study
Introduction Previous studies show poorer short-term prognosis after an acute myocardial infarction (AMI) in subjects with a low socioeconomic status (SES). Yet, the magnitude of these relations may differ by age and sex. Data on these issues are however scarce.
Methods A nationwide Dutch cohort of first AMI patients between January 1st 1998 and December 31st 2007 was identified through linkage of national registers. SES was defined as the standardized disposable income on household level in 1997. For every SES quintile, age- and sex- specific short-term mortality rates were quantified. Logistic regression models were used to estimate differences between SES quintiles in out-of-hospital mortality and 28-day case-fatality.
Results We identified 70.368 first AMI patients with income data available, of which 55.860 were men and 14.508 were women. There were strong inverse associations between SES and both short-term mortality outcomes when comparing the lowest with the highest income quintile (out-of-hospital mortality: Odds Ratio (OR) 1.26; 95% Confidence Interval (95% CI) 1.18–1.34), 28-day case-fatality: OR 1.26; 95% CI 1.15–1.37). For men graded relations were found across quintiles of SES, whereas for women only differences between the lowest and the highest quintile were seen. These relations remained consistent across all age categories, except for women below 55 years of age.
Conclusion The results from our nationwide study show an increased risk of short-term mortality after a first AMI in subjects with a low SES of all ages, which is most pronounced in men.
- © 2012 by American Heart Association, Inc.