Abstract 11922: Impact of Income Status on Prognosis of Acute Coronary Syndrome Patients During a Period of Financial Crisis - Insights From a Greek Prospective Multicenter Observational Study
Introduction: The effect of income status on patient outcome merits investigation during periods of financial crisis.
Hypothesis: We evaluated the impact of income status on out-of-hospital prognosis in a cohort of acute coronary syndrome (ACS) patients, included in a countrywide study during a period of financial crisis.
Methods: The study is a secondary analysis of a prospective, multicenter, observational study - the PHAETHON study - enrolling consecutive ACS patients in 37 hospitals in Greece. Patients were classified as low- or high-income based on the reported net annual household income using as a cut-off point the relative poverty threshold for Greece of 12000 Euros. The outcome measure was survival free of the primary composite endpoint (cardiovascular death, myocardial infarction, stroke/transient ischemic attack, urgent revascularization and urgent hospitalization due to cardiovascular causes).
Results: The study population included 794 patients. The administration rate of evidence-based medications was similar in the low- (n=455) and high-income (n=339) groups during hospitalization and upon discharge. In a median follow-up of 189 days (interquartile range: 180-212 days), low-income patients had 92% higher risk of the combined endpoint as compared to high-income patients [Hazard ratio (HR):1.92, 95%CI:1.25-2.94, p=0.003]. The effect of low-income status on the combined outcome remained significant after adjustment for age, gender and depression (HR:1.59, 95% CI:1.02-2.49; p=0.043).
Conclusions: In a period of financial crisis, low income is a significant and independent predictor of poor out-of-hospital outcome in ACS patients. This association has profound implications and should be taken into consideration by public health policy makers.
Author Disclosures: G. Andrikopoulos: None. S. Tzeis: None. D. Terentes-Printzios: None. C. Varounis: None. C. Vlachopoulos: None. I. Mantas: None. S. Patsilinakos: None. S. Lampropoulos: None. C. Olympios: None. A. Kartalis: None. A. Manolis: None. A. Gotsis: None. F. Triposkiadis: None. T. Tsaknakis: None. I. Goudevenos: None. I. Kaprinis: None. A. Pras: None. F. Vasiliou: None. E. Skoumpourdis: None. G. Sakka: None. A. Draganigos: None. P. Vardas: None.
- © 2015 by American Heart Association, Inc.