Abstract
BackgroundIncreasingly studies have identified socioeconomic factors adversely affecting healthcare outcomes for a multitude of diseases. To date, however, there has not been a study correlating socioeconomic details from nationwide databases on the prevalence of advanced coronary artery disease. We seek to identify whether socioeconomic factors contribute to advanced coronary artery disease prevalence in the United States.Methods and FindingsState specific prevalence data was queried form the United States Nationwide Inpatient Sample for 2009. Patients undergoing percutaneous coronary angioplasty and coronary artery bypass graft were identified as principal procedures. Non-cardiac related procedures, lung lobectomy and hip replacement (partial and total) were identified and used as control groups. Information regarding prevalence was then merged with data from the Behavioral Risk Factor Surveillance System, the largest, on-going telephone health survey system tracking health conditions and risk behaviors in the United States. Pearson's correlation coefficient was calculated for individual socioeconomic variables including employment status, level of education, and household income. Household income and education level were inversely correlated with the prevalence of percutaneous coronary angioplasty (−0.717; −0.787) and coronary artery bypass graft surgery (−0.541; −0.618). This phenomenon was not seen in the non-cardiac procedure control groups. In multiple linear regression analysis, socioeconomic factors were significant predictors of coronary artery bypass graft and percutaneous transluminal coronary angioplasty (p<0.001 and p = 0.005, respectively).ConclusionsSocioeconomic status is related to the prevalence of advanced coronary artery disease as measured by the prevalence of percutaneous coronary angioplasty and coronary artery bypass graft surgery.
Highlights
Despite preventive measures and aggressive therapy, coronary artery disease (CAD) is responsible for one out of every six deaths in the United States [1]
Socioeconomic status is related to the prevalence of advanced coronary artery disease as measured by the prevalence of percutaneous coronary angioplasty and coronary artery bypass graft surgery
Using a disease prevalence approach rather than risk factor analysis, we aim to identify the significance of distinct populations based on income, education level, and employment status as they relate to advanced CAD
Summary
Despite preventive measures and aggressive therapy, coronary artery disease (CAD) is responsible for one out of every six deaths in the United States [1]. It is well known that a multitude of modifiable risk factors contribute to coronary artery disease. These factors include cholesterol levels, smoking status, hypertension, obesity, psychosocial status, consumption of fruits, vegetables, alcohol, physical activity, smoking status, and many more [2] [3]. Modification of these risk factors, presumably as a result of preventive outpatient care, can have dramatic effects on the primary prevention of CAD.
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