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. 2022 Apr 25:9:847982.
doi: 10.3389/fcvm.2022.847982. eCollection 2022.

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

Helena Tizón-Marcos  1   2   3   4 , Beatriz Vaquerizo  1   2   3   4   5 , Josepa Mauri Ferré  6   7 , Núria Farré  1   2   3   4   5 , Rosa-Maria Lidón  4   8 , Joan Garcia-Picart  9 , Ander Regueiro  10 , Albert Ariza  11 , Xavier Carrillo  6 , Xavier Duran  3   12 , Paul Poirier  13 , Mercè Cladellas  1   2   3   5 , Anna Camps-Vilaró  3   4 , Núria Ribas  1   2   3   5 , Hector Cubero-Gallego  1   2   3 , Jaume Marrugat  3   4
Affiliations

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

Helena Tizón-Marcos et al. Front Cardiovasc Med. .

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: ST-elevation myocardial infarction; inequalities; mortality; primary percutaneous coronary intervention; reperfusion.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
“Codi IAM” ST-elevation myocardial infarction (STEMI) patient inclusion flowchart.
Figure 2
Figure 2
Cumulative survival according to socioeconomic status (SES). Global log-ranked p-values = 0.79; mid SES vs. low SES = 0.78; high SES vs. low SES = 0.49.
See this image and copyright information in PMC

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