Abstract 11464: Socially Disadvantaged City Districts Show a Higher Incidence of Acute ST-Elevation Myocardial Infarctions With Higher 1-Year-Mortality and Elevated Cardiovascular Risk Factors - Results From the Bremen Stemi Registry
Background: The influence of social status and occurrence of ST-elevation myocardial infarctions (STEMIs) is widely unknown. Aim of our study was to analyze the association of social status in different city districts of Bremen/Germany with STEMI incidence as well as treatment quality and prognosis.
Methods: All patients(pts) with STEMI from the metropolitan area of Bremen/Germany are admitted to the Bremen heart center and documented in the Bremen STEMI-registry (BSR).Utilizing postal codes of their home addresses all patients with STEMI from 2006 to 2011 were assigned to four quartiles in accordance to the Bremen social disadvantage index (SDI); Q1:high, Q2: intermediate high, Q3: intermediate low, Q4 low.
Results: A total of n=2061 STEMIs were admitted to the Bremen heart center between 2006 and 2011. A decreasing social status was associated with a gradual increase of age- and gender- adjusted STEMI-incidence (per 100 000 inhabitants/year): Q1 47±5, Q2 55±3, Q3 62±4, Q4 66±5 (Anova Q1-Q4 p<0.01). Pts. from socially disadvantaged city districts were more likely to smoke and to be obese.However no difference in gender distribution, prevalence of diabetes, severity of STEMI as well as treatment quality could be observed. While pts. from all quartiles showed similar in-hospital age-adjusted mortality rates an increased 1-year-mortality could be observed in pts. from socially disadvantaged city districts.
Conclusions: When assigning patients with STEMI to social clusters utilizing postal codes of their home addresses a direct association between STEMI-incidence and presumed social status can be observed. Furthermore patients with STEMI from socially disadvantaged city districts are on average younger, more likely to smoke and to be obese and showed a higher 1-year-mortality after STEMI. These data demonstrate that efforts/programs in primary and secondary cardiovascular prevention should in particular be organized in socially disadvantaged city districts.
- © 2013 by American Heart Association, Inc.