The impact of socioeconomic status on clinical features and outcomes of acute myocardial infarctions

Abstract

The main objective of this study was to examine the relationship between socioeconomic status, clinical covariates, treatments, and outcomes of acute myocardial infarction. 'Research questions'. (1) Does socioeconomic status (SES) have an impact on outcomes of AMI? (2) What might be the clinical reasons for socioeconomic differences in mortality? (3) After taking comorbidities and treatment differences into account, does socioeconomic status influence survival after acute myocardial infarction? 'Results'. Patients from the lowest income quintile tended to be unmarried, older, and female. Addition of socioeconomic status to the logistic regression models revealed that even after controlling for numerous demographic and clinical risk factors, income level was still a significant predictor of mortality after AMI. Patients who belonged to the highest income group (Q5) had a better short-term and long-term survival after AMI. The overall model performance was very good with the ROC area statistics for 30-day, 1-year, and 5-year mortality, being 0.83, 0.84, and 0.86 respectively. Similarly, after controlling for the demographic characteristics and medical therapies received in the hospital, socioeconomic status still played an important role in the outcome of AMI. Socioeconomic status appears to affect utilization of beta-blockers, heparin and thrombolytic therapy. (Abstract shortened by UMI.)