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. 2010 May 10:10:235.
doi: 10.1186/1471-2458-10-235.

Marital status and occupation in relation to short-term case fatality after a first coronary event--a population based cohort

Sofia Gerward  1 , Patrik Tydén, Gunnar Engström, Bo Hedblad
Affiliations

Marital status and occupation in relation to short-term case fatality after a first coronary event--a population based cohort

Sofia Gerward et al. BMC Public Health. .

Abstract

Background: Although marital status and low occupation level has been associated with mortality, the relationship with case fatality rates (CFR) after a coronary event (CE) is unclear. This study explored whether incidence of CE and short-term CFR differ between groups defined in terms of marital status and occupation, and if this could be explained by biological and life-style risk factors.

Methods: Population-based cohort study of 33,224 subjects (67% men), aged 27 to 61 years, without history of myocardial infarction, who were enrolled between 1974 and 1992. Incidence of CE, and CFR (death during the first day or within 28 days after CE, including out-of-hospital deaths) was examined over a mean follow-up of 21 years.

Results: A total of 3,035 men (6.0 per 1000 person-years) and 507 women (2.4 per 1000) suffered a first CE during follow-up. CFR (during the 1st day) was 29% in men and 23% in women. After risk factor adjustments, unmarried status in men, but not in women, was significantly associated with increased risk of suffering a CE [hazard ratios (HR) 1.10, 95% CI: 0.97-1.24; 1.42: 1.27-1.58 and 1.77: 1.31-2.40 for never married, divorced and widowed, respectively, compared to married]. Unmarried status, in both gender, was also related with an increased CFR (1st day), taking potential confounders into account (odds ratio (OR) 2.14, 95% CI: 1.63-2.81; 1.91: 1.50-2.43 and 1.49: 0.77-2.89 for never married, divorced and widowed, respectively, compared to married men. Corresponding figures for women was 2.32: 0.93-5.81; 1.87: 1.04-3.36 and 2.74: 1.03-7.28. No differences in CFR (1st day) were observed between occupational groups in neither gender.

Conclusions: In this population-based Swedish cohort, short-term CFR was significantly related to unmarried status in men and women. This relationship was not explained by biological-, life-style factors or occupational level.

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Figures

Figure 1
Figure 1
Crude coronary event free survival in relation to marital status in men.
Figure 2
Figure 2
Kaplan-Meier curves of 28-day survival following first coronary event in relation to marital status. Men are presented in Figure 2A, and women in 2B.
Figure 3
Figure 3
Hazard ratios for incident coronary event by occupational level in men (M) and women (W). Age-adjusted hazard ratios (HR), with 95% confidence interval (CI) is presented, using high-level non-manual occupation level as the reference group.
See this image and copyright information in PMC

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