Compared with high socioeconomic status, very low socioeconomic status was independently associated with a higher 5-year risk of MACCE after STEMI (HR 2.45; 95% CI 1.54-3.92).
Cohort (n=2,807)
No
Does low socioeconomic status increase the risk of major adverse cardiac and cerebrovascular events in patients after STEMI?
Socioeconomic disadvantage is independently associated with worse long-term cardiovascular outcomes after STEMI despite similar acute care, highlighting the need for targeted secondary prevention.
Effect estimate: HR 2.45 (95% CI 1.54-3.92)
Socioeconomic status (SES) influences cardiovascular risk, but its impact in contemporary ST-segment elevation myocardial infarction (STEMI) care remains uncertain. We examined SES-related differences in risk profile, acute care, and 5-year outcomes among consecutive STEMI patients treated at a regional referral heart center (2015-2022). SES was assigned using the neighborhood-level Social Deprivation Index and categorized as high, intermediate, low, or very low based on composite indicators of income, employment, housing, education, political participation, and security. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE) through 60 months, analyzed with multivariable models adjusting for demographics, traditional risk factors, interventional success, and infarct severity. Among 2,807 patients, 497 (17.7%) had low SES and 207 (7.4%) very low SES. Compared with high SES, very low SES patients were >5 years younger (63.3±12.4 vs 68.8±13.3 years; p<0.001) and had higher BMI, more diabetes, and more smoking (all p<0.001). Acute presentation, infarct characteristics, and in-hospital outcomes were broadly comparable across SES strata. Over 5 years, low and very low SES were independently associated with higher MACCE risk versus high SES (HR 1.85, 95% CI 1.28-2.68; and HR 2.45, 95% CI 1.54-3.92). In conclusion, socioeconomic disadvantage is associated with earlier presentation and worse long-term outcomes despite similar acute care, supporting targeted post-discharge secondary prevention.
Kerniss et al. (Fri,) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=2,807). Low and very low socioeconomic status vs. High socioeconomic status was evaluated on Major adverse cardiac and cerebrovascular events (MACCE) (HR 2.45, 95% CI 1.54-3.92). Compared with high socioeconomic status, very low socioeconomic status was independently associated with a higher 5-year risk of MACCE after STEMI (HR 2.45; 95% CI 1.54-3.92).