Associations of area based deprivation status and individual educational attainment with incidence, treatment, and prognosis of first coronary event in Rome, Italy

Picciotto, Sally; Forastiere, Francesco; Stafoggia, Massimo; D'lppoliti, Daniela; Ancona, Carla; Perucci, Carlo A.
January 2006
Journal of Epidemiology & Community Health;Jan2006, Vol. 60 Issue 1, p37
Academic Journal
Background: Socioeconomic gradients in the occurrence of myocardial infarction are well known, but few studies have examined socioeconomic disparities in post-infarction outcomes. The objective of this study was to explore relations of socioeconomic status with the incidence, treatment, and outcome of first coronary event in Rome, Italy, during the period 1998-2000, examining effect modification by gender. Methods: Subjects were Rome residents aged 35-84 years who died from first acute coronary event before reaching the hospital (n = 3470) or were hospitalised for first acute myocardial infarction (n = 8467). Area based deprivation status and patients' educational attainment were the exposure variables. The outcomes were: incidence of coronary event; recanalisation at the index hospitalisation and fatality within 28 days of hospitalisation; cardiac readmissions and fatality between 28 days and one year of index hospitalisation. Results: Incidence rates increased as area based deprivation status increased; the effect was stronger among women than among men (men RR = 1.40, 95%CI: 1.30, 1.50, women RR =1.78, 95%Cl: 1.60, 1.98, most compared with least deprived). Rates of recanalisation were significantly lower in the most deprived patients than in the least deprived (OR = 0.77, 95%Cl:0.59, 0.99) and in the less educated than in the highly educated (OR = 0.73, 95%CI:0.58, 0.90). Associations of short term fatality with area based deprivation status and educational attainment were weak and inconsistent. However, neither deprivation status nor education was associated with one year outcomes. Conclusions: Area based deprivation status is strongly related to incidence of coronary events, and more so among women than among men. Deprivation status and educational attainment are weakly and inconsistently associated with short term fatality but seem not to influence one year prognosis of acute myocardial infarction. Deprived and less educated patients experience limited access to recanalisation procedures.


Related Articles

  • Increasing socioeconomic inequalities in first acute myocardial infarction in Scotland, 1990-92 and 2000-02. Davies, Carolyn A.; Dundas, Ruth; Leyland, Alastair H. // BMC Public Health;2009, Vol. 9 Issue 1, p1 

    Background: Despite substantial declines, Ischaemic Heart Disease (IHD) remains the largest cause of death in Scotland and mortality rates are among the worst in Europe. There is evidence of strong, persisting regional and socioeconomic inequalities in IHD mortality, with the majority of such...

  • Cardiac care service use, satisfaction affected by socioeconomic status.  // PharmacoEconomics & Outcomes News;3/27/2004, Issue 449, p8 

    Discusses research being done on the socioeconomic status, service patterns and perceptions of care among survivors of acute myocardial infarction in Canada. Reference to a study by D. A. Alter et al published in the March 3, 2004 issue of the "Journal of the American Medical Association";...

  • Second MIs plummet but GP prevention remains uneven.  // Pulse;9/3/2005, Vol. 65 Issue 34, p15 

    Reports on the results of a study which revealed the decline in the number of hospitalizations for second myocardial infarction (MI) in Great Britain. Illustration of the success of secondary prevention; Results of a second study which suggests that the benefits of secondary prevention are not...

  • MI RATES FALLING.  // Bandolier;Jul2006, Vol. 13 Issue 7, p4 

    The article focuses on the hospital admission rates for myocardial infarction in Holland. The hospital admission rates are determined in terms of the age and gender of the patients. The overall incidence in terms of age and gender decline. Some of the reasons behind the decline in hospital...

  • The prognostic value of different glucose abnormalities in patients with acute myocardial infarction treated invasively. Mazurek, Michal; Kowalczyk, Jacek; Lenarczyk, Radoslaw; Zielinska, Teresa; Sedkowska, Agnieszka; Pruszkowska-Skrzep, Patrycja; Swiatkowski, Andrzej; Sredniawa, Beata; Kowalski, Oskar; Polonski, Lech; Strojek, Krzysztof; Kalarus, Zbigniew // Cardiovascular Diabetology;2012, Vol. 11 Issue 1, p78 

    Background: Diabetes (DM) deteriorates the prognosis in patients with coronary heart disease. However, the prognostic value of different glucose abnormalities (GA) other than DM in subjects with acute myocardial infarction (AMI) treated invasively remains unclear. Aims: To assess the incidence...

  • Population Trends in the Incidence and Outcomes of Acute Myocardial Infarction. Yeh, Robert W.; Sidney, Stephen; Chandra, Malini; Sorel, Michael; Selby, Joseph V.; Go, Alan S. // New England Journal of Medicine;6/10/2010, Vol. 362 Issue 23, p2155 

    Background: Few studies have characterized recent population trends in the incidence and outcomes of myocardial infarction. Methods: We identified patients 30 years of age or older in a large, diverse, community-based population who were hospitalized for incident myocardial infarction between...

  • New Technology.  // Healthcare Purchasing News;Feb2009, Vol. 33 Issue 2, p34 

    The article discusses research being done on smoking. It references studies including one on the impact of a smoke-free policy on heart attack hospitalizations in Pueblo, Colorado that was published in "Morbidity and Mortality Weekly Report," and another on third-hand smoke that was published in...

  • Prolonged pain to hospital time is associated with increased plasma advanced oxidation protein products and poor prognosis in patients with percutaneous coronary intervention for ST-elevation myocardial infarction. Yi Feng; Chengxing Shen; Genshan Ma; Jihui Wang; Zhong Chen; Qiming Dai; Hong Zhi; Chengjian Yang; Qiang Fu; Gensheng Shang; Yuanyuan Guan // Heart & Vessels;Sep2010, Vol. 25 Issue 5, p374 

    Plasma advanced oxidation protein products (AOPP) are a biomarker for increased production of reactive oxygen species. We examined the possible association between pain to hospital time, plasma AOPP, and outcome of patients receiving percutaneous coronary intervention (PCI) for ST-elevation...

  • A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction: major adverse cardiac events during long-term follow-up. Politi, Luigi; Sgura, Fabio; Rossi, Rosario; Monopoli, Daniel; Guerri, Elisa; Leuzzi, Chiara; Bursi, Francesca; Sangiorgi, Giuseppe Massimo; Modena, Maria Grazia // Heart;May2010, Vol. 96 Issue 9, p662 

    Background Few reports described outcomes of complete compared with infarct-related artery (IRA)-only revascularisation in patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD). Moreover, no studies have compared the simultaneous treatment of...


Read the Article


Sign out of this library

Other Topics