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The association between socioeconomic position, use of revascularization procedures and five-year survival after recovery from acute myocardial infarction

Rosvall, Maria LU ; Chaix, Basile LU ; Lynch, John; Lindström, Martin LU and Merlo, Juan LU (2008) In BMC Public Health 8(44).
Abstract
Background: Patients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction ( AMI) compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation- wide longitudinal study we wanted to evaluate long- term survival after AMI in relation to socioeconomic position ( SEP) and use of revascularization. Methods: From the Swedish Myocardial Infarction Register we identified all 45 to 84- year- old patients ( 16,041 women and 30,366 men) alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization,... (More)
Background: Patients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction ( AMI) compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation- wide longitudinal study we wanted to evaluate long- term survival after AMI in relation to socioeconomic position ( SEP) and use of revascularization. Methods: From the Swedish Myocardial Infarction Register we identified all 45 to 84- year- old patients ( 16,041 women and 30,366 men) alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization, cumulative household income from the 1975 and 1990 censuses and 5- year survival after the AMI. Results: Patients with the highest cumulative income ( adding the values of the quartile categories of income in 1975 and 1990) underwent a revascularization procedure within one month after their first AMI two to three times as often as patients with the lowest cumulative income and had half the risk of death within five years. The socioeconomic differences in the use of revascularization procedures could not be explained by differences in co- morbidity or type of hospital at first admission. Patients who underwent revascularization showed a similar lowered mortality risk in the different income groups, while there were strong socioeconomic differences in long- term mortality among patients who did not undergo revascularization. Conclusion: This nationwide Swedish study showed that patients with high income had a better long- term survival after recovery from their AMI compared to patients with low income. Furthermore, even though the use of revascularization procedures is beneficial, low SEP groups receive it less often than high SEP groups. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Public Health
volume
8
issue
44
publisher
BioMed Central
external identifiers
  • wos:000254550400001
  • scopus:43349101251
ISSN
1471-2458
DOI
10.1186/1471-2458-8-44
language
English
LU publication?
yes
id
1ca10c0f-e656-4cca-8985-c48a21ec9361 (old id 1183021)
date added to LUP
2008-09-02 11:00:04
date last changed
2017-08-27 04:43:58
@article{1ca10c0f-e656-4cca-8985-c48a21ec9361,
  abstract     = {Background: Patients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction ( AMI) compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation- wide longitudinal study we wanted to evaluate long- term survival after AMI in relation to socioeconomic position ( SEP) and use of revascularization. Methods: From the Swedish Myocardial Infarction Register we identified all 45 to 84- year- old patients ( 16,041 women and 30,366 men) alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization, cumulative household income from the 1975 and 1990 censuses and 5- year survival after the AMI. Results: Patients with the highest cumulative income ( adding the values of the quartile categories of income in 1975 and 1990) underwent a revascularization procedure within one month after their first AMI two to three times as often as patients with the lowest cumulative income and had half the risk of death within five years. The socioeconomic differences in the use of revascularization procedures could not be explained by differences in co- morbidity or type of hospital at first admission. Patients who underwent revascularization showed a similar lowered mortality risk in the different income groups, while there were strong socioeconomic differences in long- term mortality among patients who did not undergo revascularization. Conclusion: This nationwide Swedish study showed that patients with high income had a better long- term survival after recovery from their AMI compared to patients with low income. Furthermore, even though the use of revascularization procedures is beneficial, low SEP groups receive it less often than high SEP groups.},
  author       = {Rosvall, Maria and Chaix, Basile and Lynch, John and Lindström, Martin and Merlo, Juan},
  issn         = {1471-2458},
  language     = {eng},
  number       = {44},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {The association between socioeconomic position, use of revascularization procedures and five-year survival after recovery from acute myocardial infarction},
  url          = {http://dx.doi.org/10.1186/1471-2458-8-44},
  volume       = {8},
  year         = {2008},
}