Findings seen during 11 years of follow-up among those having a heart attack at age 50 years or younger
FRIDAY, May 21, 2021 (HealthDay News) — Neighborhood and socioeconomic factors play an important role in long-term survival in younger patients after a myocardial infarction (MI), according to a study published online May 19 in JAMA Cardiology.
Adam N. Berman, M.D., from Harvard Medical School in Boston, and colleagues used data from 2,002 patients experiencing an MI at 50 years of age or younger (between Jan. 1, 2000, and April 30, 2016) to determine the association between neighborhood-level socioeconomic disadvantage and long-term MI outcomes. Home address was mapped to the Area Deprivation Index.
The researchers found that patients in the most disadvantaged neighborhoods were more likely to be Black or Hispanic, have public insurance or no insurance, and have higher rates of traditional cardiovascular risk factors such as hypertension and diabetes. Among the 1,964 patients who survived to hospital discharge, 13.6 percent in the most disadvantaged group died during a median 11.3 years of follow-up versus 12.6 percent in the middle group and 5.7 percent in the least disadvantaged group. Higher neighborhood disadvantage was associated with higher all-cause mortality and cardiovascular mortality (hazard ratios, 1.32 and 1.57, respectively), even when adjusting for clinical covariates.
“While our findings may be limited in terms of generalizability to other states and practice settings, they may actually be amplified in other geographic areas with weaker social safety nets,” Berman said in a statement. “This highlights the importance of future research in this area, not only to identify the problem, but to implement interventions on a policy level to narrow these disparities and improve outcomes in communities with fewer resources.”
Several authors disclosed financial ties to the pharmaceutical industry.
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