Abstract
Cardiovascular problems are still the leading cause of deaths globally. Socioeconomic inequality continues to pose a challenge to health care suppliers and can greatly affect the clinical outcome of medical problems, especially in the cardiovascular field. This study aimed to assess the in-hospital outcome of patients with acute coronary syndrome admitted in the coronary care unit and to determine the relation between socioeconomic status (SES) and in-hospital outcome of acute coronary syndrome. A prospective observational study was conducted on 301 patients presented with acute coronary syndrome during the period from August 2015 to May 2016. A questionnaire was used to assess their socioeconomic status. Admitted patients with acute coronary syndrome (ACS) were classified into 31 (10.3%) patients with non-ST segment elevation myocardial infarction (NSTEMI), 162 (53.8%) with ST segment elevation myocardial infarction STEMI and 108 (35.9%) with unstable angina (UA). According to patients SES, they were classified as 77 with high SES, 74 with middle SES, 84 with low SES, and 66 with very low SES. The study revealed that the lower socioeconomic status was statistically significant associated with increase of acute coronary syndrome mortality (P <0.001), the incidence of impaired left ventricular function, heart failure and stroke was associated. While, lower socioeconomic status was significantly associated decrease in the incidence of coronary angiography and percutaneous intervention. No significant change in the incidence of arrhythmia and major bleeding between socioeconomic status classes. Lower socioeconomic status in patients with acute coronary syndrome was considered as a risk factor for increased in-hospital mortality, stroke, impaired left ventricular function, and heart failure. To the best of author’s knowledge, this study considered first report in Egypt discussing the in-hospital outcome of patients with ACS and to determine the relation between SES and in-hospital outcome of ACS patients.
Highlights
Coronary heart disease (CHD) is a main cause of mortality and disability all over the world
In the United States, nearly one-half of middleaged men and one-third of middle-aged women will develop manifestation of acute coronary syndrome (ACS) which can be presented with unstable angina, non-ST segment elevation myocardial infarction (NSTEMI) or ST segment elevation (STEMI) [2]
Socioeconomic status didn't affect the type of presentation of ACS
Summary
Coronary heart disease (CHD) is a main cause of mortality and disability all over the world. Its mortality rates have been declined over the past few decades, CHD accounts for about one-third or more of all deaths in individuals over 35 years [1]. In the United States, nearly one-half of middleaged men and one-third of middle-aged women will develop manifestation of acute coronary syndrome (ACS) which can be presented with unstable angina, non-ST segment elevation myocardial infarction (NSTEMI) or ST segment elevation (STEMI) [2]. Short term outcome (in-hospital or 30 days outcome) of patients with acute MI has been decreased over the past 30 years, concomitantly with the increasing use of reperfusion strategies and proven preventive therapies as beta blockers, aspirin and statins [3]. A similar trend was observed in analysis of data on 2.5 million patients from the American national registry of MI. in which in-hospital mortality after
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