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Socioeconomic status and in‑hospital mortality of acute coronary syndrome: can education and occupation serve as preventive measures?
Mid Sweden University, Sundsvall, Sweden; Tehran University of Medical Sciences, Tehran, Iran; Iranian Petroleum Health Research Institute, Tehran, Iran .
Karolinska Institutet, Stockholm, Sweden; Universidade do Estado de Rio de Janeiro, Brazil.
Tehran University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
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2015 (English)In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 6, 36Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in-hospital mortality of patients with the acute coronary syndrome (ACS) according to their SES.

METHODS: All patients admitted to Tehran Heart Center due to 1(st)-time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low-SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high-SES patients. Demographic, clinical, paraclinical, and in-hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in-hospital mortality was evaluated.

RESULTS: A total of 6246 hospitalized patients (3290 low SES and 2956 high SES) were included (mean age = 60.3 ± 12.1 years, male = 2772 [44.4%]). Among them, 79 (1.26%) patients died. Univariable analysis showed a significantly higher mortality rate in the low-SES group (1.9% vs. 0.6%; P < 0.001). After adjustment for possible cofounders, SES still showed a significant effect on the in-hospital mortality of the ACS patients in that the high-SES patients had a lower in-hospital mortality rate (odds ratio: 0.304, 95% confidence interval: 0.094-0.980; P = 0.046).

CONCLUSIONS: This study found that patients with low SES were at a higher risk of in-hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.

Place, publisher, year, edition, pages
2015. Vol. 6, 36
Keyword [en]
Coronary disease, education, mortality, occupation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hig:diva-19424DOI: 10.4103/2008-7802.156266ISI: 000209980200001PubMedID: 25984286Scopus ID: 2-s2.0-84930911813OAI: oai:DiVA.org:hig-19424DiVA: diva2:815799
Available from: 2015-06-01 Created: 2015-06-01 Last updated: 2017-12-07Bibliographically approved

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