2023-09-28 14:46:10 +00:00
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abstract: 'Little is known about the impact of socioeconomic status (SES) on
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management strategies and in-hospital clinical outcomes in patients with
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acute myocardial infarction (AMI) and its subtypes, and whether these
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trends have changed over time. All AMI hospitalizations from the
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National Inpatient Sample (2004 to 2014) were analyzed and stratified by
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zip code-based median household income (MHI) into 4 quartiles (poorest
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to wealthiest): 0th to 25th, 26th to 50th, 51st to 75 th , and 76th to
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100th. Logistic regression was performed to examine the association
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between MHI and AMI management strategy and in-hospital clinical
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outcomes. A total of 6,603,709 AMI hospitalizations were analyzed.
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Patients in the lowest MHI group had more co-morbidities, a worse
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cardiovascular risk factor profile and were more likely to be female.
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Differences in receipt of invasive management were observed between the
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lowest and highest MID quartiles, with the lowest MHI group less likely
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to undergo coronary angiography (63.4\% vs 64.3\%, p <0.001) and
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percutaneous coronary intervention (40.4\% vs 44.3\%, p <0.001) compared
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with the highest MHI group, especially in the STEMI subgroup. In
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multivariable analysis, the highest MHI group experienced better
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outcomes including lower risk (adjusted odds ratio; 95\% confidence
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intervals) of mortality (0.88; 0.88 to 0.89), MACCE (0.91; 0.91 to 0.92)
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and acute ischemic stroke (0.90; 0.88 to 0.91), but higher all-cause
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bleeding (1.08; 1.06 to 1.09) in comparison to the lowest MHI group. In
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conclusion, the provision of invasive management for AMI in patients
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with lower SES is less than patients with higher SES and is associated
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with worse in-hospital clinical outcomes. This work highlights the
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importance of ensuring equity of access and care across all strata SES.
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(C) 2020 Elsevier Inc. All rights reserved.'
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affiliation: 'Mamas, MA (Corresponding Author), Keele Univ, Ctr Prognosis Res, Keele
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Cardiovasc Res Grp, Keele, Staffs, England.
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Mamas, MA (Corresponding Author), Royal Stoke Univ Hosp, Dept Cardiol, Stoke On
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Trent, Staffs, England.
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Mamas, MA (Corresponding Author), Thomas Jefferson Univ Hosp, Dept Med Cardiol,
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Philadelphia, PA 19107 USA.
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Matetic, Andrija, Univ Hosp Split, Dept Cardiol, Split, Croatia.
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Bharadwaj, Aditya, Loma Linda Univ, Med Ctr, Loma Linda, CA 92350 USA.
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Mohamed, Mohamed O.; Mamas, Mamas A., Keele Univ, Ctr Prognosis Res, Keele Cardiovasc
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Res Grp, Keele, Staffs, England.
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Mohamed, Mohamed O.; Mamas, Mamas A., Royal Stoke Univ Hosp, Dept Cardiol, Stoke
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On Trent, Staffs, England.
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Chugh, Yashasvi, Mt Sinai St Lukes Roosevelt Hosp, New York, NY USA.
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Chugh, Sanjay, Jaipur Natl Univ Hosp \& Med Coll, IMSRC, Jaipur, Rajasthan, India.
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Minissian, Margot, Cedars Sinai Med Ctr, Barbara Streisand Womens Heart Ctr, Smidt
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Heart Inst, Los Angeles, CA 90048 USA.
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Amin, Amit, Washington Sch Med, St Louis, MO USA.
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Van Spall, Harriette, McMaster Univ, Dept Med, Hamilton, ON, Canada.
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Van Spall, Harriette, Populat Hlth Res Inst, Hamilton, ON, Canada.
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Fischman, David L.; Savage, Michael; Mamas, Mamas A., Thomas Jefferson Univ Hosp,
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Dept Med Cardiol, Philadelphia, PA 19107 USA.
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Volgman, Annabelle Santos, Rush Med Coll, Dept Med, Sect Cardiol, Chicago, IL 60612
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USA.'
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author: Matetic, Andrija and Bharadwaj, Aditya and Mohamed, Mohamed O. and Chugh,
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Yashasvi and Chugh, Sanjay and Minissian, Margot and Amin, Amit and Van Spall, Harriette
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and Fischman, David L. and Savage, Michael and Volgman, Annabelle Santos and Mamas,
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Mamas A.
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author-email: mamasmamas1@yahoo.co.uk
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author_list:
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- family: Matetic
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given: Andrija
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- family: Bharadwaj
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given: Aditya
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- family: Mohamed
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given: Mohamed O.
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- family: Chugh
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given: Yashasvi
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- family: Chugh
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given: Sanjay
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- family: Minissian
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given: Margot
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- family: Amin
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given: Amit
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- family: Van Spall
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given: Harriette
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- family: Fischman
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given: David L.
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- family: Savage
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given: Michael
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- family: Volgman
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given: Annabelle Santos
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- family: Mamas
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given: Mamas A.
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da: '2023-09-28'
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doi: 10.1016/j.amjcard.2020.05.025
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eissn: 1879-1913
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files: []
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issn: 0002-9149
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journal: AMERICAN JOURNAL OF CARDIOLOGY
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keywords-plus: RISK-FACTORS; HEALTH; MORTALITY; DISPARITIES; INDICATORS; AREA
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language: English
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month: AUG 15
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number-of-cited-references: '23'
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orcid-numbers: 'Volgman, Annabelle/0000-0002-9918-0878
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Mohamed, Mohamed/0000-0002-9678-5222
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Mohamed, Mohamed Osama/0000-0002-9678-5222
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Mamas, Mamas Andreas/0000-0001-9241-8890
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Van Spall, Harriette Gillian Christine/0000-0002-8370-4569
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Chugh, Yashasvi/0000-0001-9724-9088
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fischman, david/0000-0001-9711-7616'
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pages: 10-18
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papis_id: c5388f544c6d3aea5f252e5d8062c34c
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ref: Matetic2020socioeconomicstatus
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researcherid-numbers: 'Volgman, Annabelle/AAF-3387-2021
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Matetic, Andrija/AAK-2351-2020
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Mohamed, Mohamed/S-9668-2017
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Mohamed, Mohamed Osama/O-8339-2019
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Mamas, Mamas Andreas/A-2549-2019
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'
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times-cited: '22'
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title: Socioeconomic Status and Differences in the Management and Outcomes of 6.6
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Million US Patients With Acute Myocardial Infarction
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000553464500003
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usage-count-last-180-days: '0'
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usage-count-since-2013: '3'
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volume: '129'
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web-of-science-categories: Cardiac \& Cardiovascular Systems
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year: '2020'
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