Background:
According to the World Health Organization, coronary artery disease (CAD), including ST-segment
elevation myocardial infarction (STEMI), is the most common cause of death worldwide as well as in Europe and
Austria. There is valid data on the impact of conventional risk factors on the medical outcomes for STEMI patients.
However, only few studies examine the role of the socio-economic environment for medical outcomes. The main
task of this study is to investigate if the socio-economic environment of patients who underwent percutaneous
coronary intervention (PCI) after STEMI has an impact on the distribution of risk factors and medical outcomes.
Methods:
The study focuses on the population of the City of Vienna, Austria, and includes 870 STEMI patients, who
underwent PCI at the General Hospital of Vienna (AKH Wien) between 2008 and 2012. The following data were
collected: conventional risk factors (hypertension, hyperlipidemia, diabetes, overweight, smoking, family history and
vascular disease) and socio-economic indicators of the patient's
residential district (number of residents, income
pre-tax, residents per general practitioner, residents per internal specialist, compulsory education only, academic
degree and rate of unemployment). Cox regressions were performed to evaluate the impact of socio-economic
environment and conventional risk factors on survival.
Results:
Most of the conventional risk factors show a significant difference between deceased and surviving patients.
The study revealed significant differences across districts in relation to the socio-economic background of STEMI
patients. Surprisingly, medical outcomes, as measured by the survival of patients, are significantly related to a patient's
district of residence (
p
-Value = 0.028) but not in a systematic way as far as the socio-economic environment of These
districts is concerned.
Conclusions:
The study provides intuitive evidence for a hitherto understudied Central European context on the link
between socio-economic environment and conventional risk factors at population level and the link between
conventional risk factors and survival both at the population at the individual level. While this is in line with previous
evidence and suggestive of the incorporation of measures of socio-economic status (SES) into policy & guidelines
toward the management of CAD, more data on the SES -
STEMI nexus are needed at individual level.
| Identifer | oai:union.ndltd.org:VIENNA/oai:epub.wu-wien.ac.at:6982 |
| Date | January 2019 |
| Creators | Roth, Christian, Berger, Rudolf, Kuhn, Michael |
| Publisher | Springer Nature |
| Source Sets | Wirtschaftsuniversität Wien |
| Language | English |
| Detected Language | English |
| Type | Article, PeerReviewed |
| Format | application/pdf |
| Rights | Creative Commons: Attribution 4.0 International (CC BY 4.0) |
| Relation | https://doi.org/10.1186/s12889-019-6966-z, https://www.springernature.com/, http://epub.wu.ac.at/6982/ |
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