Impact of Socioeconomic Status on In-Hospital Outcome of Patients with Acute Coronary Syndrome in Egypt

Cardiovascular problems are still the leading cause of deaths globally. Socioeconomic inequality continues to pose a challenge to health care suppliers and can greatly affect the clinical outcome of medical problems, especially in the cardiovascular field. This study aimed to assess the in-hospital outcome of patients with acute coronary syndrome admitted in the coronary care unit and to determine the relation between socioeconomic status (SES) and in-hospital outcome of acute coronary syndrome. A prospective observational study was conducted on 301 patients presented with acute coronary syndrome during the period from August 2015 to May 2016. A questionnaire was used to assess their socioeconomic status. Admitted patients with acute coronary syndrome (ACS) were classified into 31 (10.3%) patients with non-ST segment elevation myocardial infarction (NSTEMI), 162 (53.8%) with ST segment elevation myocardial infarction STEMI and 108 (35.9%) with unstable angina (UA). According to patients SES, they were classified as 77 with high SES, 74 with middle SES, 84 with low SES, and 66 with very low SES. The study revealed that the lower socioeconomic status was statistically significant associated with increase of acute coronary syndrome mortality (P <0.001), the incidence of impaired left ventricular function, heart failure and stroke was associated. While, lower socioeconomic status was significantly associated decrease in the incidence of coronary angiography and percutaneous intervention. No significant change in the incidence of arrhythmia and major bleeding between socioeconomic status classes. Lower socioeconomic status in patients with acute coronary syndrome was considered as a risk factor for increased in-hospital mortality, stroke, impaired left ventricular function, and heart failure. To the best of author’s knowledge, this study considered first report in Egypt discussing the in-hospital outcome of patients with ACS and to determine the relation between SES and in-hospital outcome of ACS patients.