Educational Level and Long-term Mortality in Patients With Acute Myocardial Infarction

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• 作者：Luciano Consuegra-S&aacute ; nchez^a ; ^{lconsue@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Antonio Melgarejo-Moreno^b ; José ; Galcer&aacute ; -Tom&aacute ; s^c ; Nuria Alonso-Fern&aacute ; ndez^b ; &Aacute ; ngela Dí ; az-Pastor^b ; Germ&aacute ; n Escudero-Garcí ; a^b ; Leticia Jaulent-Huertas^a ; Marta Vicente-Gilabert^c
• 关键词：Myocardial infarction ; Educational level ; Prognosis ; Socioeconomic status
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：68
• 期：11
• 页码：935-942
• 全文大小：299 K

文摘

The value of socioeconomic status as a prognostic marker in acute myocardial infarction is controversial. The aim of this study was to evaluate the impact of educational level, as a marker of socioeconomic status, on the prognosis of long-term survival after acute myocardial infarction.

Methods

We conducted a prospective, observational study of 5797 patients admitted to hospital with acute myocardial infarction. We studied long-term all-cause mortality (median 8.5 years) using adjusted regression models.

Results

We found that 73.1% of patients had primary school education (n = 4240), 14.5% had secondary school education (including high school) (n = 843), 7.0% was illiterate (n = 407), and 5.3% had higher education (n = 307). Patients with secondary school or higher education were significantly younger, more were male, and they had fewer risk factors and comorbidity. These patients arrived sooner at hospital and had less severe heart failure. During admission they received more reperfusion therapy and their crude mortality was lower. Their drug treatment in hospital and at discharge followed guideline recommendations more closely. On multivariate analysis, secondary school or higher education was an independent predictor and protective factor for long-term mortality (hazard ratio = 0.85; 95% confidence interval, 0.74-0.98).

Conclusions

Our study shows an inverse and independent relationship between educational level and long-term mortality in patients with acute myocardial infarction.