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. 2025 May 6;17(5):e83551.
doi: 10.7759/cureus.83551. eCollection 2025 May.

Socioeconomic Disparities and In-Hospital Outcomes in Acute Myocardial Infarction: A Case-Control Study

Eman Shaban  1 , Eman Khashaba  2 , Ensaf Bassam  3 , Ayman A Abdelaziz  3 , Amira Shaban  4 , Ahmed Shaban  4   5 , Hany A Zaki  6
Affiliations

Socioeconomic Disparities and In-Hospital Outcomes in Acute Myocardial Infarction: A Case-Control Study

Eman Shaban et al. Cureus. .

Abstract

Purpose: This study aimed to assess the impact of socioeconomic status (SES) primarily on in-hospital outcomes, while also exploring its association with the incidence of acute myocardial infarction (AMI).

Methods: This was a case-control study that included 100 patients with first-onset AMI and 100 age- and sex-matched controls without clinical or investigative evidence of cardiac disease, confirmed by history, ECG, and absence of prior hospitalizations. Data collection involved demographics, cardiovascular risk factors (e.g., smoking, obesity, hypertension), blood pressure, BMI, echocardiography, and laboratory investigations, used diagnostically and prognostically. SES was assessed at admission using the Egyptian socioeconomic scale (total score: 84), covering seven domains. SES was categorized into very low (<40), low (40-56.9), middle (57-64.9), and high (>65). Assessing SES before outcome measurement reduced reverse causation risk.

Results: Occurrences and in-hospital outcomes, such as cardiogenic shock, were significantly more common among AMI patients from lower SES groups compared to higher SES groups (p < 0.05). Mortality was also higher in the lower SES group, with an odds ratio of 4.8 (95% confidence interval (CI): 1.5-16.6), indicating a more than fourfold increased risk. However, the wide CI suggests some uncertainty in the estimate, likely due to the limited sample size. In-hospital complications were reported in 41.1% of patients with low and very low SES (39 patients), compared to 20.4% (21 patients) and 32.7% (32 patients) in the middle and high SES groups, respectively.

Conclusion: These findings highlight that SES significantly shapes in-hospital outcomes among patients with first-onset AMI. Patients from lower SES groups experienced more frequent complications and higher mortality. While comorbid conditions such as hypertension, diabetes, and obesity were more prevalent in lower SES groups, SES itself served as the primary exposure variable influencing outcomes, rather than being evaluated through the presence of comorbidities.

Keywords: case-control study; heart; in-hospital outcome; myocardial infarction; socioeconomic status (ses).

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Medical Research Ethics Committee, Mansoura University issued approval MS/758. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. In-hospital complications and mortality stratified by socioeconomic status
See this image and copyright information in PMC

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References

    1. Cardiac troponin and defining myocardial infarction. Kaier TE, Alaour B, Marber M. Cardiovasc Res. 2021;117:2203–2215. - PMC - PubMed
    1. Mechanical complications of myocardial infarction. Murphy A, Goldberg S. Am J Med. 2022;135:1401–1409. - PubMed
    1. Myocardial infarction with and without ST-segment elevation: a contemporary reappraisal of similarities and differences. Mitsis A, Gragnano F. Curr Cardiol Rev. 2021;17:0. - PMC - PubMed
    1. Right ventricular myocardial infarction: pathophysiology, clinical implications and management. Femia G, French JK, Juergens C, Leung D, Lo S. Rev Cardiovasc Med. 2021;22:1229–1240. - PubMed
    1. Diabetes mellitus and acute myocardial infarction: impact on short and long-term mortality. Milazzo V, Cosentino N, Genovese S, Campodonico J, Mazza M, De Metrio M, Marenzi G. Adv Exp Med Biol. 2021;1307:153–169. - PubMed

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