What question did this study set out to answer?

To determine the impact of socioeconomic status, age, and sex on coronary event incidence, hospital admission rates, and case fatality.

February 22, 1997BMJOpen Access

Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: analysis of community coronary event register

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Why the study?

Does socioeconomic deprivation increase the incidence and mortality of myocardial infarction and coronary death in adults aged 25-64?

Population

5,542 adults aged 25-64 years on the Glasgow MONICA coronary event register with definite or fatal possible…

Comparison

Most deprived socioeconomic quarter (Q4) vs Least deprived socioeconomic quarter (Q1)

Design

Cohort

Follow-up

28 days

Authors

MWMark WoodwardUniversité Claude Bernard Lyon 1 WLW. S. LeslieGlasgow Royal Infirmary HTH Tunstall-PedoeAmerican Heart Association

Discussion

Member takes

Implication

Socioeconomic deprivation was associated with higher coronary event rates and fatality; leaves open whether targeted prevention can reduce disparities.

Key Points

To determine the impact of socioeconomic status, age, and sex on coronary event incidence, hospital admission rates, and case fatality.
Analyzed data from the Glasgow MONICA community coronary event register from 1985 to 1991, evaluating a population of 196,000.
Included 3,991 men and 1,551 women aged 25–64 years with definite, fatal possible, or unclassifiable coronary events according to WHO MONICA criteria.
Assessed event rates, hospital admission proportions, and case fatality rates across socioeconomic deprivation quartiles (Q1 least deprived to Q4 most deprived).
Coronary event rates increased from Q1 to Q4 by 1.7-fold in men and 2.4-fold in women, with a steeper socioeconomic gradient observed in women.
The proportion of patients reaching hospital alive (66% overall) decreased with increasing deprivation (age-standardized OR 0.82 for Q4 vs Q1).
Overall community case fatality was 50% and rose with deprivation (age-standardized OR 1.12 in men, 1.18 in women), with 68% of all coronary deaths occurring prior to hospital admission.

Structured PICO

Does socioeconomic deprivation increase the incidence and mortality of myocardial infarction and coronary death in adults aged 25-64?

Population

5,542 adults (3,991 men and 1,551 women) aged 25-64 years on the Glasgow MONICA coronary event register with definite or fatal possible or unclassifiable myocardial infarction and coronary death events.

Intervention

Most deprived socioeconomic quarter (Q4)

Comparator

Least deprived socioeconomic quarter (Q1)

Outcome

Rate of coronary events, proportion of subjects reaching hospital alive, case fatality in admitted patients, and overall case fatality in the community at 28 dayshard clinical

Socioeconomic deprivation significantly increases the incidence of coronary events and prehospital mortality, highlighting the need for primary and secondary prevention to reduce mortality variations.

Limitations

Specific populations in each socioeconomic quarter for each year were not available, requiring use of 1991 census data as denominator for 1985-1991 data.
Non-fatal events in deprived people may be less frequently recognised, potentially making the denominator for case fatality in more deprived groups comparatively more incomplete.

Cite This Study

Woodward et al. (1997) studied this question.

synapsesocial.com/papers/6a7cd620854948aad28d1835 https://doi.org/10.1136/bmj.314.7080.541

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Implication

Socioeconomic deprivation was associated with higher coronary event rates and fatality; leaves open whether targeted prevention can reduce disparities.

Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: analysis of community coronary event register

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: analysis of community coronary event register

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider