Socio-economic position and time trends in invasive management and case fatality after acute myocardial infarction in Denmark
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Socio-economic position and time trends in invasive management and case fatality after acute myocardial infarction in Denmark. / Mårtensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva; Andersen, Per Kragh; Jacobsen, Rikke Kart; Osler, Merete.
In: European Journal of Public Health, Vol. 26, No. 1, 02.2016, p. 146-152.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Socio-economic position and time trends in invasive management and case fatality after acute myocardial infarction in Denmark
AU - Mårtensson, Solvej
AU - Gyrd-Hansen, Dorte
AU - Prescott, Eva
AU - Andersen, Per Kragh
AU - Jacobsen, Rikke Kart
AU - Osler, Merete
N1 - © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
PY - 2016/2
Y1 - 2016/2
N2 - BACKGROUND: Lower case fatality and increased use of evidence-based invasive management incl. coronary angiography (CAG) have been reported for patients admitted with acute myocardial infarction (AMI) in the last 25 years. This article seeks to investigate whether these advances have benefitted patients in all socio-economic groups and how this has impacted on inequality in case fatality.METHODS: Forty three thousand eight hundred and forty three patients admitted with AMI in the period from 2001 to 2009 were included. Socio-economic position was measured using individual information on education. Age-standardized cumulative incidence of CAG within 1, 3 and 30 days along with age-standardized case fatality within 30 and 365 days were estimated. Cox regression models were used to model the relative inequality over time.RESULTS: Use of CAG within 1, 3 and 30 days increased for all educational groups over time and the inequality in CAG within 1 and 3 days seen in the beginning of the time frame was eliminated. Case fatality decreased in all educational groups and the relative inequality in 30 days case fatality decreased for women but not 365 days case fatality. No change was seen for inequality in case fatality for men.CONCLUSION: Increased use of CAG within the evidence based time frame was observed along with a decrease in inequality. However, a reduction in inequality was only observed for short term case fatality, and only for women. These results suggest that inequality in case fatality is not primarily driven by inequality in invasive management of AMI.
AB - BACKGROUND: Lower case fatality and increased use of evidence-based invasive management incl. coronary angiography (CAG) have been reported for patients admitted with acute myocardial infarction (AMI) in the last 25 years. This article seeks to investigate whether these advances have benefitted patients in all socio-economic groups and how this has impacted on inequality in case fatality.METHODS: Forty three thousand eight hundred and forty three patients admitted with AMI in the period from 2001 to 2009 were included. Socio-economic position was measured using individual information on education. Age-standardized cumulative incidence of CAG within 1, 3 and 30 days along with age-standardized case fatality within 30 and 365 days were estimated. Cox regression models were used to model the relative inequality over time.RESULTS: Use of CAG within 1, 3 and 30 days increased for all educational groups over time and the inequality in CAG within 1 and 3 days seen in the beginning of the time frame was eliminated. Case fatality decreased in all educational groups and the relative inequality in 30 days case fatality decreased for women but not 365 days case fatality. No change was seen for inequality in case fatality for men.CONCLUSION: Increased use of CAG within the evidence based time frame was observed along with a decrease in inequality. However, a reduction in inequality was only observed for short term case fatality, and only for women. These results suggest that inequality in case fatality is not primarily driven by inequality in invasive management of AMI.
U2 - 10.1093/eurpub/ckv156
DO - 10.1093/eurpub/ckv156
M3 - Journal article
C2 - 26342131
VL - 26
SP - 146
EP - 152
JO - European Journal of Public Health
JF - European Journal of Public Health
SN - 1101-1262
IS - 1
ER -
ID: 160410129