Socioeconomic Status and Prognosis of Patients With ST-Elevation Myocardial Infarction Managed by the Emergency-Intervention "Codi IAM" Network

Despite the spread of ST-elevation myocardial infarction (STEMI) emergency intervention networks, inequalities in healthcare access still have a negative impact on cardiovascular prognosis. The Family Income Ratio of Barcelona (FIRB) is a socioeconomic status (SES) indicator that is annually calcula...

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Bibliographic Details
Authors: Tizón-Marcos, Helena|||0000-0001-7942-9413, Vaquerizo, Beatriz|||0000-0002-1428-3596, Ferré, Josepa Mauri, Farré, Núria|||0000-0003-3110-6572, Lidón, Rosa María|||0000-0001-7008-2716, García Picart, Joan, Regueiro, Ander|||0000-0001-5201-447X, Ariza-Solé, Albert|||0000-0002-0819-6656, Carrillo, Xavier|||0000-0001-6691-8859, Duran-Jordà, Xavier|||0000-0001-8517-9254, Poirier, Paul, Cladellas Capdevila, Mercè|||0000-0001-8537-6012, Camps-Vilaró, Anna|||0000-0001-9644-8421, Ribas Barquet, Núria|||0000-0003-1492-5285, Cubero-Gallego, Hector|||0000-0001-9740-827X, Marrugat, Jaume|||0000-0003-3320-554X
Format: article
Publication Date:2022
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:282865
Online Access:https://ddd.uab.cat/record/282865
https://dx.doi.org/urn:doi:10.3389/fcvm.2022.847982
Access Level:Open access
Keyword:Inequalities
Mortality
Primary percutaneous coronary intervention
Reperfusion
ST-elevation myocardial infarction
Description
Summary:Despite the spread of ST-elevation myocardial infarction (STEMI) emergency intervention networks, inequalities in healthcare access still have a negative impact on cardiovascular prognosis. The Family Income Ratio of Barcelona (FIRB) is a socioeconomic status (SES) indicator that is annually calculated. Our aim was to evaluate whether SES had an effect on mortality and complications in patients managed by the "Codi IAM" network in Barcelona. This is a cohort study with 3,322 consecutive patients with STEMI treated in Barcelona from 2010 to 2016. Collected data include treatment delays, clinical and risk factor characteristics, and SES. The patients were assigned to three SES groups according to FIRB score. A logistic regression analysis was conducted to estimate the adjusted effect of SES on 30-day mortality, 30-day composite cardiovascular end point, and 1-year mortality. The mean age of the patients was 65 ± 13% years, 25% were women, and 21% had diabetes mellitus. Patients with low SES were younger, more often hypertensive, diabetic, dyslipidemic (p < 0.003), had longer reperfusion delays (p < 0.03) compared to participants with higher SES. Low SES was not independently associated with 30-day mortality (OR: 0.95;9 5% CI: 0.7-1.3), 30-day cardiovascular composite end point (OR: 1.03; 95% CI: 0.84-1.26), or 1-year all-cause mortality (HR: 1.09; 95% CI: 0.76-1.56). Although the low-SES patients with STEMI in Barcelona city were younger, had worse clinical profiles, and had longer revascularization delays, their 30-day and 1-year outcomes were comparable to those of the higher-SES patients.

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