RT Journal Article
SR Electronic
T1 Impact of socioeconomic status on adverse cardiac events after coronary angioplasty: a cohort study
JF Heart Asia
FD BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association
SP e010960
DO 10.1136/heartasia-2017-010960
VO 10
IS 2
A1 Hashir Kareem
A1 Prasad Narayana Shetty
A1 Tom Devasia
A1 Yeshwanth Rao Karkala
A1 Ganesh Paramasivam
A1 Vasudev Guddattu
A1 Ajit Singh
A1 Sheetal Chauhan
YR 2018
UL http://heartasia.bmj.com/content/10/2/e010960.abstract
AB Background Socioeconomic status (SES) has been associated with adverse cardiovascular events in coronary atherosclerotic disease. However, it is unclear how SES impacts adverse cardiac events in patients treated with percutaneous coronary intervention (PCI). Methods We determined SES based on educational, economic and occupational parameters for 630 consecutive patients who underwent PCI at our centre between 01 June 2015 and 01 June 2016. The patients were divided into low and high SES groups, and they were followed up for 12 months. Patients were matched at baseline for demographic and procedural characteristics; multivariate analysis was used to adjust for baseline and procedural variables. Postprocedure compliance to medications was analysed. At 12 months, the primary composite end point of major adverse cardiac events (MACE) — consisting of death, non-fatal myocardial infarction, target lesion revascularisation, target vessel revascularisation — was compared between the groups. Results The high SES group had a higher prevalence of diabetes mellitus (p=0.03; OR 0.74%, 95% CI 0.53% to 1.03%) and a stronger family history of ischaemic heart disease (p=0.003; OR 0.53%, 95% CI 0.33% to 0.84%). Low SES was associated with lower compliance with medication (p=0.01; OR 2.22%, 95% CI 1.19% to 4.15%). At 12 months, the primary composite end point of MACE was found to be higher in the low SES group (p=0.01); higher MACE was primarily driven by cardiac mortality (p<0.001). Low SES was found to be an independent predictor of MACE (HR 1.84%, 95% CI 1.16% to 2.96%).Conclusion Low SES was associated with a higher incidence of major adverse cardiac events in patients undergoing PCI and was an independent predictor of MACE at 12 months.