170 lines
5.4 KiB
YAML
170 lines
5.4 KiB
YAML
abstract: 'Background: For women, who are more likely to live in poverty, defining
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the clinical and economic impact of socioeconomic factors may aid in
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defining redistributive policies to improve healthcare quality.
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Methods. The NIH-NHLBI-sponsored Women''s Ischemia Syndrome Evaluation
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(WISE) enrolled 819 women referred for clinically indicated coronary
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angiography. This study''s primary end point was to evaluate the
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independent contribution of socioeconomic factors on the estimation of
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time to cardiovascular death or myocardial infarction (MI) (n = 79)
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using Cox proportional hazards models. Secondary aims included an
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examination of cardiovascular costs and quality of life within
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socioeconomic subsets of women.
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Results: In univariable models, socioeconomic factors associated with an
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elevated risk of cardiovascular death or MI included an annual household
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income <\$20,000 (p = 0.0001), <9th grade education (p = 0.002), being
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African American, Hispanic, Asian, or American Indian (p = 0.016), on
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Medicaid, Medicare, or other public health insurance (p < 0.0001),
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unmarried (p = 0.001.), unemployed or employed part-time (p < 0.0001),
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and working in a service job (p = 0.003). Of these socioeconomic
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factors, income (p = 0.006) remained a significant predictor of
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cardiovascular death or MI in risk-adjusted models that controlled for
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angiographic coronary disease, chest pain symptoms, and cardiac risk
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factors. Low-income women, with an annual household income <\$20,000,
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were more often uninsured or on public insurance (p < 0.0001) yet had
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the highest 5-year hospitalization and drug treatment costs (p <
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0.0001). Only 17\% of low-income women had prescription drug coverage
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(vs. >= 50\% of higher-income households, p < 0.0001), and 64\% required
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>= 2 anti-ischemic medications during follow-up (compared with 45\% of
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those earning >=\$50,000, p < 0.0001).
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Conclusions: Economic disadvantage prominently affects cardiovascular
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disease outcomes for women with chest pain symptoms. These results
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further support a profound intertwining between poverty and poor health.
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Cardiovascular disease management strategies should focus on policies
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that track unmet healthcare needs and worsening clinical status for
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low-income women.'
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affiliation: 'Shaw, LJ (Corresponding Author), Emory Univ, Sch Med, Dept Med, Div
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Cardiol,Emory Program Cardiovasc Outcome Res, Suite 1 North,1256 Briarcliff Rd NE,
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Atlanta, GA 30306 USA.
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Shaw, Leslee J., Emory Univ, Sch Med, Dept Med, Div Cardiol,Emory Program Cardiovasc
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Outcome Res, Atlanta, GA 30306 USA.
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Merz, C. Noel Bairey, Cedars Sinai Med Ctr, Cedars Sinai Res Inst, Los Angeles,
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CA 90048 USA.
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Bittner, Vera; Rogers, William J., Univ Alabama, Dept Med, Div Cardiovasc Dis, Birmingham,
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AL 35294 USA.
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Kip, Kevin; Johnson, B. Delia; Kelsey, Sheryl F.; Olson, Marian, Univ Pittsburgh,
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Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA.
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Reis, Steven E., Univ Pittsburgh, Med Ctr, Cardiovasc Inst, Pittsburgh, PA USA.
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Mankad, Sunil, Allegheny Univ Hlth Sci, Dept Med, Div Cardiol, Pittsburgh, PA USA.
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Sharaf, Barry L., Rhode Isl Hosp, Div Cardiol, Providence, RI USA.
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Pohost, Gerald M., Univ So Calif, Div Cardiol, Los Angeles, CA USA.
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Sopko, George, NHLBI, NIH, Bethesda, MD 20892 USA.
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Pepine, Carl J., Univ Florida, Dept Med, Div Cardiol, Gainesville, FL USA.'
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author: Shaw, Leslee J. and Merz, C. Noel Bairey and Bittner, Vera and Kip, Kevin
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and Johnson, B. Delia and Reis, Steven E. and Kelsey, Sheryl F. and Olson, Marian
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and Mankad, Sunil and Sharaf, Barry L. and Rogers, William J. and Pohost, Gerald
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M. and Sopko, George and Pepine, Carl J. and Investigators, WISE
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author-email: leslee.shaw@emory.edu
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author_list:
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- family: Shaw
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given: Leslee J.
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- family: Merz
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given: C. Noel Bairey
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- family: Bittner
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given: Vera
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- family: Kip
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given: Kevin
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- family: Johnson
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given: B. Delia
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- family: Reis
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given: Steven E.
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- family: Kelsey
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given: Sheryl F.
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- family: Olson
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given: Marian
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- family: Mankad
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given: Sunil
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- family: Sharaf
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given: Barry L.
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- family: Rogers
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given: William J.
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- family: Pohost
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given: Gerald M.
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- family: Sopko
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given: George
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- family: Pepine
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given: Carl J.
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- family: Investigators
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given: WISE
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da: '2023-09-28'
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doi: 10.1089/jwh.2007.0596
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files: []
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issn: 1540-9996
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journal: JOURNAL OF WOMENS HEALTH
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keywords-plus: 'CORONARY-ARTERY DISEASE; FUNCTIONAL-CAPACITY; ETHNIC-DIFFERENCES;
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RISK-FACTORS; SOCIAL-CLASS; CHEST PAIN; ATHEROSCLEROSIS; INEQUALITIES;
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MORTALITY; POSITION'
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language: English
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month: SEP
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number: '7'
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number-of-cited-references: '38'
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orcid-numbers: 'Bittner, Vera/0000-0001-9456-850X
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Reis, Steven/0000-0001-8023-0102'
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pages: 1081-1092
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papis_id: e3ada099da419ebd7d0a498382be0ab2
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ref: Shaw2008importancesocioecono
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researcherid-numbers: 'Reis, Steven E/J-3957-2014
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Kip, Kevin/HOH-9165-2023
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'
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times-cited: '34'
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title: Importance of socioeconomic status as a predictor of cardiovascular outcome
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and costs of care in women with suspected myocardial ischemia. Results from the
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National Institutes of Health, National Heart, Lung and Blood Institute-sponsored
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Women's Ischemia Syndrome Evaluation (WISE)
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type: article
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unique-id: WOS:000259639200005
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usage-count-last-180-days: '0'
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usage-count-since-2013: '12'
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volume: '17'
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web-of-science-categories: 'Public, Environmental \& Occupational Health; Medicine,
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General \&
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Internal; Obstetrics \& Gynecology; Women''s Studies'
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year: '2008'
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