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Type: Journal article
Title: The association between socioeconomic position, use of revascularization procedures and five-year survival after recovery from acute myocardial infarction
Author: Rosvall, M.
Chaix, B.
Lynch, J.
Lindstrom, M.
Merlo, J.
Citation: BMC Public Health, 2008; 8(44):1-11
Publisher: BioMed Central Ltd.
Issue Date: 2008
ISSN: 1471-2458
Statement of
Maria Rosvall, Basile Chaix, John Lynch, Martin Lindström, and Juan Merlo
Abstract: Background: Patients living under better socioeconomic circumstances often receive more active treatments after an acute myocardial infarction (AMI) compared to less affluent patients. However, most previous studies were performed in countries with less comprehensive coverage for medical services. In this Swedish nation-wide longitudinal study we wanted to evaluate long-term survival after AMI in relation to socioeconomic position (SEP) and use of revascularization. Methods: From the Swedish Myocardial Infarction Register we identified all 45 to 84-year-old patients (16,041 women and 30,366 men) alive 28 days after their first AMI during the period 1993 to 1996. We obtained detailed information on the use of revascularization, cumulative household income from the 1975 and 1990 censuses and 5-year survival after the AMI. Results: Patients with the highest cumulative income (adding the values of the quartile categories of income in 1975 and 1990) underwent a revascularization procedure within one month after their first AMI two to three times as often as patients with the lowest cumulative income and had half the risk of death within five years. The socioeconomic differences in the use of revascularization procedures could not be explained by differences in co-morbidity or type of hospital at first admission. Patients who underwent revascularization showed a similar lowered mortality risk in the different income groups, while there were strong socioeconomic differences in long-term mortality among patients who did not undergo revascularization. Conclusion: This nationwide Swedish study showed that patients with high income had a better long-term survival after recovery from their AMI compared to patients with low income. Furthermore, even though the use of revascularization procedures is beneficial, low SEP groups receive it less often than high SEP groups.
Keywords: Humans; Myocardial Infarction; Patient Admission; Myocardial Revascularization; Hospital Mortality; Survival Rate; Data Interpretation, Statistical; Age Factors; Sex Factors; Recovery of Function; Social Class; Aged; Aged, 80 and over; Middle Aged; Income; Sweden; Female; Male; Outcome Assessment, Health Care
Rights: © 2008 Rosvall et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
RMID: 0020106542
DOI: 10.1186/1471-2458-8-44
Appears in Collections:Public Health publications

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