abstract: 'Little is known about the impact of socioeconomic status (SES) on

  management strategies and in-hospital clinical outcomes in patients with

  acute myocardial infarction (AMI) and its subtypes, and whether these

  trends have changed over time. All AMI hospitalizations from the

  National Inpatient Sample (2004 to 2014) were analyzed and stratified by

  zip code-based median household income (MHI) into 4 quartiles (poorest

  to wealthiest): 0th to 25th, 26th to 50th, 51st to 75 th , and 76th to

  100th. Logistic regression was performed to examine the association

  between MHI and AMI management strategy and in-hospital clinical

  outcomes. A total of 6,603,709 AMI hospitalizations were analyzed.

  Patients in the lowest MHI group had more co-morbidities, a worse

  cardiovascular risk factor profile and were more likely to be female.

  Differences in receipt of invasive management were observed between the

  lowest and highest MID quartiles, with the lowest MHI group less likely

  to undergo coronary angiography (63.4\% vs 64.3\%, p <0.001) and

  percutaneous coronary intervention (40.4\% vs 44.3\%, p <0.001) compared

  with the highest MHI group, especially in the STEMI subgroup. In

  multivariable analysis, the highest MHI group experienced better

  outcomes including lower risk (adjusted odds ratio; 95\% confidence

  intervals) of mortality (0.88; 0.88 to 0.89), MACCE (0.91; 0.91 to 0.92)

  and acute ischemic stroke (0.90; 0.88 to 0.91), but higher all-cause

  bleeding (1.08; 1.06 to 1.09) in comparison to the lowest MHI group. In

  conclusion, the provision of invasive management for AMI in patients

  with lower SES is less than patients with higher SES and is associated

  with worse in-hospital clinical outcomes. This work highlights the

  importance of ensuring equity of access and care across all strata SES.

  (C) 2020 Elsevier Inc. All rights reserved.'
affiliation: 'Mamas, MA (Corresponding Author), Keele Univ, Ctr Prognosis Res, Keele
  Cardiovasc Res Grp, Keele, Staffs, England.

  Mamas, MA (Corresponding Author), Royal Stoke Univ Hosp, Dept Cardiol, Stoke On
  Trent, Staffs, England.

  Mamas, MA (Corresponding Author), Thomas Jefferson Univ Hosp, Dept Med Cardiol,
  Philadelphia, PA 19107 USA.

  Matetic, Andrija, Univ Hosp Split, Dept Cardiol, Split, Croatia.

  Bharadwaj, Aditya, Loma Linda Univ, Med Ctr, Loma Linda, CA 92350 USA.

  Mohamed, Mohamed O.; Mamas, Mamas A., Keele Univ, Ctr Prognosis Res, Keele Cardiovasc
  Res Grp, Keele, Staffs, England.

  Mohamed, Mohamed O.; Mamas, Mamas A., Royal Stoke Univ Hosp, Dept Cardiol, Stoke
  On Trent, Staffs, England.

  Chugh, Yashasvi, Mt Sinai St Lukes Roosevelt Hosp, New York, NY USA.

  Chugh, Sanjay, Jaipur Natl Univ Hosp \& Med Coll, IMSRC, Jaipur, Rajasthan, India.

  Minissian, Margot, Cedars Sinai Med Ctr, Barbara Streisand Womens Heart Ctr, Smidt
  Heart Inst, Los Angeles, CA 90048 USA.

  Amin, Amit, Washington Sch Med, St Louis, MO USA.

  Van Spall, Harriette, McMaster Univ, Dept Med, Hamilton, ON, Canada.

  Van Spall, Harriette, Populat Hlth Res Inst, Hamilton, ON, Canada.

  Fischman, David L.; Savage, Michael; Mamas, Mamas A., Thomas Jefferson Univ Hosp,
  Dept Med Cardiol, Philadelphia, PA 19107 USA.

  Volgman, Annabelle Santos, Rush Med Coll, Dept Med, Sect Cardiol, Chicago, IL 60612
  USA.'
author: Matetic, Andrija and Bharadwaj, Aditya and Mohamed, Mohamed O. and Chugh,
  Yashasvi and Chugh, Sanjay and Minissian, Margot and Amin, Amit and Van Spall, Harriette
  and Fischman, David L. and Savage, Michael and Volgman, Annabelle Santos and Mamas,
  Mamas A.
author-email: mamasmamas1@yahoo.co.uk
author_list:
- family: Matetic
  given: Andrija
- family: Bharadwaj
  given: Aditya
- family: Mohamed
  given: Mohamed O.
- family: Chugh
  given: Yashasvi
- family: Chugh
  given: Sanjay
- family: Minissian
  given: Margot
- family: Amin
  given: Amit
- family: Van Spall
  given: Harriette
- family: Fischman
  given: David L.
- family: Savage
  given: Michael
- family: Volgman
  given: Annabelle Santos
- family: Mamas
  given: Mamas A.
da: '2023-09-28'
doi: 10.1016/j.amjcard.2020.05.025
eissn: 1879-1913
files: []
issn: 0002-9149
journal: AMERICAN JOURNAL OF CARDIOLOGY
keywords-plus: RISK-FACTORS; HEALTH; MORTALITY; DISPARITIES; INDICATORS; AREA
language: English
month: AUG 15
number-of-cited-references: '23'
orcid-numbers: 'Volgman, Annabelle/0000-0002-9918-0878

  Mohamed, Mohamed/0000-0002-9678-5222

  Mohamed, Mohamed Osama/0000-0002-9678-5222

  Mamas, Mamas Andreas/0000-0001-9241-8890

  Van Spall, Harriette Gillian Christine/0000-0002-8370-4569

  Chugh, Yashasvi/0000-0001-9724-9088

  fischman, david/0000-0001-9711-7616'
pages: 10-18
papis_id: c5388f544c6d3aea5f252e5d8062c34c
ref: Matetic2020socioeconomicstatus
researcherid-numbers: 'Volgman, Annabelle/AAF-3387-2021

  Matetic, Andrija/AAK-2351-2020

  Mohamed, Mohamed/S-9668-2017

  Mohamed, Mohamed Osama/O-8339-2019

  Mamas, Mamas Andreas/A-2549-2019

  '
times-cited: '22'
title: Socioeconomic Status and Differences in the Management and Outcomes of 6.6
  Million US Patients With Acute Myocardial Infarction
type: article
unique-id: WOS:000553464500003
usage-count-last-180-days: '0'
usage-count-since-2013: '3'
volume: '129'
web-of-science-categories: Cardiac \& Cardiovascular Systems
year: '2020'