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Coronary heart disease incidence and short-term case fatality in relation to socio-economic circumstances - epidemiological and clinical aspects

Gerward, Sofia LU (2010) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2010:81.
Abstract
The aim of this thesis was to study incidence and case-fatality rate (CFR) of myocardial infarction (MI) and ischemic heart disease (IHD), by exploring relations to socioeconomic position (SEP), other cardiovascular risk factors, medical seeking pattern and time trends.

Data from the Malmö Myocardial Infarction Register (1986-1995; n=5533), the Malmö 1990 cohort (1990-2003; n=69 223), the Malmö Preventive Project (19742004; n=33 224) and out-of-hospital IHD deaths in southern Sweden (1992-2003; n=14 347) were used. The incidence and mortality of MI and IHD were followed using national and local registers.

In patients below 75 years, 28-day CFR and survival after first MI was inverse associated to the SEP of the... (More)
The aim of this thesis was to study incidence and case-fatality rate (CFR) of myocardial infarction (MI) and ischemic heart disease (IHD), by exploring relations to socioeconomic position (SEP), other cardiovascular risk factors, medical seeking pattern and time trends.

Data from the Malmö Myocardial Infarction Register (1986-1995; n=5533), the Malmö 1990 cohort (1990-2003; n=69 223), the Malmö Preventive Project (19742004; n=33 224) and out-of-hospital IHD deaths in southern Sweden (1992-2003; n=14 347) were used. The incidence and mortality of MI and IHD were followed using national and local registers.

In patients below 75 years, 28-day CFR and survival after first MI was inverse associated to the SEP of the patient’s residential area. Both incidence and 28-day CFR after first MI were inversely related to income, out-of-hospital deaths (i.e. pre-hospital deaths) having the largest differences. Preceding their MI death, low compared to high income groups had more frequently contacted the medical services. Being unmarried, independently of other risk factors, increased the risk for and dying from a first coronary event (CE). In southern Sweden deaths due to IHD occurring out-of-hospital has during the period 1992 to 2003 decreased significantly, however, being more in men. The proportion of IHD deaths occurring outside hospital was higher in younger than older cases.

In conclusion, living in a deprived area, having a low income and being unmarried increase the risk for a CE, decreases the chance of reaching hospital alive and increases the risk of dying from the event. (Less)
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author
supervisor
opponent
  • Prof Swahn, Eva, Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Sweden
organization
publishing date
type
Thesis
publication status
published
subject
keywords
gender, cohort study, epidemiology, socio-economic factors, risk factors, mortality, myocardial infarction, ischemic heart disease, coronary heart disease
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2010:81
pages
124 pages
publisher
Lund University, Faculty of Medicine
defense location
Lecture hall, Clinical Research Centre, Entrance 72, Skåne University Hospital in Malmö
defense date
2010-09-17 09:00
ISSN
1652-8220
ISBN
978-91-86443-97-9
language
English
LU publication?
yes
id
c587936d-af70-4b99-8b81-b92ca26de657 (old id 1662333)
date added to LUP
2010-09-01 09:43:15
date last changed
2018-05-29 12:10:19
@phdthesis{c587936d-af70-4b99-8b81-b92ca26de657,
  abstract     = {The aim of this thesis was to study incidence and case-fatality rate (CFR) of myocardial infarction (MI) and ischemic heart disease (IHD), by exploring relations to socioeconomic position (SEP), other cardiovascular risk factors, medical seeking pattern and time trends. <br/><br>
Data from the Malmö Myocardial Infarction Register (1986-1995; n=5533), the Malmö 1990 cohort (1990-2003; n=69 223), the Malmö Preventive Project (19742004; n=33 224) and out-of-hospital IHD deaths in southern Sweden (1992-2003; n=14 347) were used. The incidence and mortality of MI and IHD were followed using national and local registers. <br/><br>
In patients below 75 years, 28-day CFR and survival after first MI was inverse associated to the SEP of the patient’s residential area. Both incidence and 28-day CFR after first MI were inversely related to income, out-of-hospital deaths (i.e. pre-hospital deaths) having the largest differences. Preceding their MI death, low compared to high income groups had more frequently contacted the medical services. Being unmarried, independently of other risk factors, increased the risk for and dying from a first coronary event (CE). In southern Sweden deaths due to IHD occurring out-of-hospital has during the period 1992 to 2003 decreased significantly, however, being more in men. The proportion of IHD deaths occurring outside hospital was higher in younger than older cases. <br/><br>
In conclusion, living in a deprived area, having a low income and being unmarried increase the risk for a CE, decreases the chance of reaching hospital alive and increases the risk of dying from the event.},
  author       = {Gerward, Sofia},
  isbn         = {978-91-86443-97-9},
  issn         = {1652-8220},
  keyword      = {gender,cohort study,epidemiology,socio-economic factors,risk factors,mortality,myocardial infarction,ischemic heart disease,coronary heart disease},
  language     = {eng},
  pages        = {124},
  publisher    = {Lund University, Faculty of Medicine},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {Coronary heart disease incidence and short-term case fatality in relation to socio-economic circumstances - epidemiological and clinical aspects},
  volume       = {2010:81},
  year         = {2010},
}