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Influence of socioeconomic status on clinical outcomes and quality of life after percutaneous coronary intervention
  1. M A Denvir1,
  2. A J Lee2,
  3. J Rysdale1,
  4. A Walker3,
  5. H Eteiba4,
  6. I R Starkey1,
  7. J P Pell4
  1. 1Centre for Cardiovascular Research, University of Edinburgh, Edinburgh, UK
  2. 2Medical Statistics Unit, University of Edinburgh
  3. 3Department of Statistics and Health Economics, University of Glasgow, Glasgow
  4. 4Department of Medical Cardiology, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to:
 M A Denvir
 Department of Cardiology, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU, UK; mdenvir{at}staffmail.ed.ac.uk

Abstract

Objectives: To determine whether socioeconomic status (SES) influences clinical outcomes and quality of life after percutaneous coronary intervention (PCI).

Design: Prospective observational study.

Setting: Two interventional cardiac centres.

Participants: 1346 consecutive patients undergoing PCI over a 12-month period.

Outcomes: Self reported health-related quality of life (HRQoL; EuroQol-5 Dimensions (EQ-5D); EuroQol Visual Analogue Scale (EQ-VAS)), repeat angiography, revascularisation, hospital admission, myocardial infarction and death within 12 months, by SES derived using postal address code.

Main results: No significant differences were found between patients with high and low SES in the occurrence of repeat angiography (p = 0.55), repeat revascularisation (PCI, p = 0.81, CAEG, p = 0.27), total cardiac hospitalisation (p = 0.10), myocardial infarction (p = 0.97) or death 12 months after PCI (p = 0.88). Non-procedure-related readmissions were higher in patients with low SES (18.6% v 13.7%; p = 0.025). After adjustment for confounding factors, patients with low SES had lower HRQoL scores at baseline (95% CI for difference 0.01 to 0.14; p = 0.003) and at 12 months (95% CI 0.07 to 0.17; p<0.001) compared with those with high SES.

Conclusions: Clinical outcomes were similar for patients in different SES groups. Patients with low SES had considerably more non-procedure-related readmissions and lower quality-of-life scores. Future studies on HRQoL after coronary revascularisation should take account of these important differences related to SES.

  • CABG, coronary artery bypass graft
  • CHD, coronary heart disease
  • depcat, deprivation category
  • EQ-5D, EuroQol-5 Dimensions
  • EQ-VAS, EuroQol Visual Analogue Scale
  • HRQoL, health-related self-reported quality of life
  • PCI, percutaneous coronary intervention
  • SES, socioeconomic status

Statistics from Altmetric.com

Footnotes

  • Funding: This study was funded by the Chief Scientist’s Office, Scottish Executive, UK.

  • Competing interests: None.

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