Impact of socioeconomic status on adverse cardiac events after coronary angioplasty: A cohort study

Hashir Kareem, Prasad Narayana Shetty, Tom Devasia, Yeshwanth Rao Karkala, Ganesh Paramasivam, Vasudev Guddattu, Ajit Singh, Sheetal Chauhan

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article numbere010960
JournalHeart Asia
Volume10
Issue number2
DOIs
Publication statusPublished - 01-05-2018

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Angioplasty
Social Class
Cohort Studies
Percutaneous Coronary Intervention
Medication Adherence
Myocardial Ischemia
Coronary Disease
Diabetes Mellitus
Multivariate Analysis
Myocardial Infarction
Economics
Demography
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kareem, Hashir ; Shetty, Prasad Narayana ; Devasia, Tom ; Karkala, Yeshwanth Rao ; Paramasivam, Ganesh ; Guddattu, Vasudev ; Singh, Ajit ; Chauhan, Sheetal. / Impact of socioeconomic status on adverse cardiac events after coronary angioplasty : A cohort study. In: Heart Asia. 2018 ; Vol. 10, No. 2.
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title = "Impact of socioeconomic status on adverse cardiac events after coronary angioplasty: A cohort study",
abstract = "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.",
author = "Hashir Kareem and Shetty, {Prasad Narayana} and Tom Devasia and Karkala, {Yeshwanth Rao} and Ganesh Paramasivam and Vasudev Guddattu and Ajit Singh and Sheetal Chauhan",
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Impact of socioeconomic status on adverse cardiac events after coronary angioplasty : A cohort study. / Kareem, Hashir; Shetty, Prasad Narayana; Devasia, Tom; Karkala, Yeshwanth Rao; Paramasivam, Ganesh; Guddattu, Vasudev; Singh, Ajit; Chauhan, Sheetal.

In: Heart Asia, Vol. 10, No. 2, e010960, 01.05.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of socioeconomic status on adverse cardiac events after coronary angioplasty

T2 - A cohort study

AU - Kareem, Hashir

AU - Shetty, Prasad Narayana

AU - Devasia, Tom

AU - Karkala, Yeshwanth Rao

AU - Paramasivam, Ganesh

AU - Guddattu, Vasudev

AU - Singh, Ajit

AU - Chauhan, Sheetal

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

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.

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U2 - 10.1136/heartasia-2017-010960

DO - 10.1136/heartasia-2017-010960

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