急性心肌梗死的管理和预后中社会经济差异与性别的交叉:全国队列研究

IF 2.6 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Angiology Pub Date : 2024-09-19 DOI:10.1177/00033197241273433
Nicholas Weight,Saadiq Moledina,Claire A Lawson,Harriette G C Van Spall,Harindra C Wijeysundera,Muhammad Rashid,Evangelos Kontopantelis,Mamas A Mamas
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引用次数: 0

摘要

与社会经济地位较高的患者相比,社会经济地位较低的患者在急性心肌梗死(AMI)后的预后较差;然而,性别如何改变社会经济差异尚不清楚。我们利用英国心肌缺血国家审计项目(MINAP)登记册和英国国家统计局(ONS)的死亡率数据,对2005年至2018年间的736420名急性心肌梗死患者进行了分析,并按多重贫困指数(IMD)五分法(最富裕[Q1]至最贫困[Q5])进行了分层。在我们的调整模型中,院内死亡概率与性别无明显差异。在我们的调整模型中,男性和女性在整个五分位数中的30天死亡率概率相似((Q5;男性7.6%;95% CI 7.3-7.8% (P < .001),女性7.0%;95% CI 6.8-7.3%, P < .001))((Q1;男性7.1%;95% CI 6.8-7.4%, P < .001,女性6.9%;95% CI 6.6-7.1%, P < .001))。在我们的调整模型中,男性在所有五分位数中的一年期死亡率均较高(Q1;男性 15.0%;95% CI 14.8-15.6%,P < .001,女性 14.5%;95% CI 14.2-14.9%,P < .001)(Q5;男性 16.9%;95% CI 16.5-17.3%,P < .001,女性 15.5%;95% CI 15.1-15.9%,P < .001)。总体而言,女性性别对贫困对急性心肌梗死护理过程和结果的影响没有明显影响。
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The Intersection of Socioeconomic Differences and Sex in the Management and Outcomes of Acute Myocardial Infarction: A Nationwide Cohort Study.
Patients with lower socioeconomic status (SES) have poorer outcomes following acute myocardial infarction (AMI) than patients with higher SES; however, how sex modifies socioeconomic differences is unclear. Using the United Kingdom (UK) Myocardial Ischaemia National Audit Project (MINAP) registry, alongside Office of National Statistics (ONS) mortality data, we analyzed 736,420 AMI patients between 2005 and 2018, stratified by Index of Multiple Deprivation (IMD) score Quintiles (most affluent [Q1] to most deprived [Q5]). There was no significant difference in probability of in-hospital mortality in our adjusted model according to sex. The probability of 30-day mortality in our adjusted model was similar between men and women throughout Quintiles, ((Q5; Men 7.6%; 95% CI 7.3-7.8% (P < .001), Women; 7.0%; 95% CI 6.8-7.3%, P < .001)) ((Q1; Men 7.1%; 95% CI 6.8-7.4%, P < .001, Women; 6.9%; 95% CI 6.6-7.1%, P < .001)). The probability of one-year mortality in our adjusted model was higher in men throughout all Quintiles (Q1; Men 15.0%; 95% CI 14.8-15.6%), P < .001, Women; 14.5%; 95% CI 14.2-14.9%, P < .001) (Q5; Men 16.9%; 95% CI 16.5-17.3%, P < .001, Women; 15.5%; 95% CI 15.1-15.9 by %, P < .001). Overall, female sex did not significantly influence the effect of deprivation on AMI processes of care and outcomes.
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来源期刊
Angiology
Angiology 医学-外周血管病
CiteScore
5.50
自引率
14.30%
发文量
180
审稿时长
6-12 weeks
期刊介绍: A presentation of original, peer-reviewed original articles, review and case reports relative to all phases of all vascular diseases, Angiology (ANG) offers more than a typical cardiology journal. With approximately 1000 pages per year covering diagnostic methods, therapeutic approaches, and clinical and laboratory research, ANG is among the most informative publications in the field of peripheral vascular and cardiovascular diseases. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 13 days
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