Background:
Low Socioeconomic Status (SES) is known to be a major risk factor for Ischemic Heart Disease (IHD) (1-4). The term SES is a complex and multifactorial contributor which effect on health at different levels (5). We examined the relation between low neighborhood socioeconomic status and short term outcomes in patients after Myocardial Infarction (MI).
Methods: Acute Coronary Syndrome Israeli Survey (ACSIS) is a biennial data collection conducted in all cardiology departments in Israel. We analyzed pilot data based on random sample of 200 patients in aim to investigate the feasibility of performing study on a large scale population. Neighborhood SES was estimated through a composite census-derived index developed by the Israel Central Bureau of Statistics. Patients were divided into “low SES” and “high SES” using their address. Individuals SES included level of education, school years, marital status, number of children, religion observance and origin. Outcome measures included in hospital complications, major advanced cardiac events (MACE) 30 days post MI and death in a 3 month following index event.
Results:patients in low SES group were younger (63.9±14.3) compared to high SES group (66.4±13.4). Overall, patients with low SES had higher rates of risk factors and previous history of IHD. Clinical measurements at arrival were worse and the door to balloon time was longer compare to high SES group. The odds ratio (OR) for in-hospital complications associated with low SES was 1.6 (CI95%0.9-7.9) .The OR for 30 day MACE associated with low SES was 2.7 (CI95% 0.9-7.9), after adjusting to individuals SES OR=2.2 (CI95% 0.6-8.8). OR for death in 3 month post MI was 1.5 (CI95% 0.5-4.9), after adjusting for individuals SES OR=1.3 (CI95% 0.3-6.5).
Conclusion: Low neighborhood socioeconomic status is associated with short term outcomes in patients after myocardial infarction. Further investigation of larger population is necessary to assess the effect of socioeconomic environment on survival.
