Key result
Lower socioeconomic levels were associated with higher 1-year mortality after acute myocardial infarction, with standardized mortality varying from 15.9 to 54.4 per 100,000 inhabitants across different geographic areas.
Why the study?
The spatial distribution of acute myocardial infarction mortality in France and its association with the socio-economic characteristics of patients' places of residence needed to be described.
Observational (n=115,418)
Yes
One-year mortality after acute myocardial infarction in France is geographically heterogeneous and strongly associated with lower socioeconomic status rather than travel time to revascularization facilities.
OBJECTIVE: To describe the spatial distribution of acute myocardial infarction (AMI) mortality in France in association with the socio-economic characteristics of the patient's place of residence. METHODS: In this population-based study, we included patients hospitalized for AMI identified according to ICD-10 codes, using data from the national health insurance database from January 1, 2013 to December 31, 2014. In- and out-of-hospital deaths were identified over a period of 1 year following the first hospital stay for AMI.An exploratory analysis was performed to classify area profiles. The spatial analysis of AMI mortality was performed using a principal component analysis followed by an ascending hierarchical classification taking into account socio-economic data, access-time by road to coronary angiography, standardized in-hospital prevalence, and 1 year mortality. RESULTS: Over the 2 years, 115,418 patients were hospitalized with a diagnosis of AMI. Patients were a mean of 68 ± 15 years and most were men (68.5%). The overall mortality rate was 12.2% after 1 year. More than half of patients (65.5%) underwent an early revascularization procedure. The map of standardized 1 year mortality showed a geographic area of high mortality extending diagonally from north-east to south-west France. We identified 6 different area profiles with standardized mortality varying from 15.9 to 54.4 per 100,000 inhabitants. The spatial distribution of higher mortality was associated with lower socioeconomic levels. These findings were not associated with a lower access to coronary angiography. CONCLUSION: There are considerable geographical differences in the prevalence of AMI and 1 year mortality. The spatial distribution of lower healthcare indicators follows the distribution of social inequalities. This study highlights the importance of focusing national policies on universally accessible prevention programs such as the promotion cardiac rehabilitation and healthy lifestyles.
No takes yet. Share an insight, caveat, or question.
Piccard et al. (2020) conducted an observational in Acute myocardial infarction (n=115,418). Socioeconomic status and geographic area was evaluated on Overall mortality at one-year. Lower socioeconomic levels were associated with higher 1-year mortality after acute myocardial infarction, with standardized mortality varying from 15.9 to 54.4 per 100,000 inhabitants across different geographic areas.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: