002: Socio-professional status as a major determinant of disparities in cardiovascular outcomes: contemporary data on the prognosis of workmen after an acute myocardial infarction

Abstract

Over the last decade in France, early prognosis after acute myocardial infarction (AMI) markedly improved. However, recent works suggest persistent socioeconomic disparities in outcomes after AMI. From a regional population-based study, we aimed to analyze the prognosis of workmen after AMI. Patients enrolled in the Observatoire des Infarctus du myocarde de Côte d’Or (RICO) between 2001 and 2011, <65 y, with current occupational activity and follow-up at one year. Socio-professional categories (SPC) were collected according to INSEE definition. The primary endpoint combined mortality and hospitalization for heart failure. Among the 1671 patients included during the study period, 403 (24%) were workmen. Mean age was 50.8 years, 85% were male and 50% had ST segment elevation MI (STEMI). Although workmen have more favorable pattern of risk factors, the rate of combined endpoint was 3 fold higher among workmen vs other SPC (7.9% vs 2.6%). Multivariate analysis showed that workmen remain strongly associated with worse prognosis, even after adjustment for confounding (OR (95%CI): 3.22(1.44–7.17)). This large contemporary study showed that the medium-term prognosis of workmen after an AMI is still worse than other SPC in France. Socio-professional status is an important determinant of population health and cardiovascular outcomes and may account for some of the heterogeneity in outcomes for patients hospitalized with AMI.