Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?
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Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina? / Mårtensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva; Andersen, Per Kragh; Gislason, Gunnar; Jacobsen, Rikke Kart; Osler, Merete.
In: EuroIntervention, Vol. 11, No. 13, 20.04.2016, p. 1495-1502.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?
AU - Mårtensson, Solvej
AU - Gyrd-Hansen, Dorte
AU - Prescott, Eva
AU - Andersen, Per Kragh
AU - Gislason, Gunnar
AU - Jacobsen, Rikke Kart
AU - Osler, Merete
PY - 2016/4/20
Y1 - 2016/4/20
N2 - Aims: Our aim was to investigate whether there is social inequality in access to invasive examination and treatment, and whether access explains social inequality in case fatality in a nationwide sample of patients admitted for the first time with unstable angina or non-ST-elevation myocardial infarction (NSTEMI) in Denmark.Methods and results: All patients admitted for the first time with NSTEMI (n=16,625) or unstable angina (n=8,800) from 2001 to 2009 in Denmark were included. We measured time from admission to coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The outcomes were 30-day and one-year case fatality. We found social inequality in access to CAG and one-year case fatality for both NSTEMI and unstable angina patients, but the time waited for CAG did not explain the social inequality in case fatality.Conclusions: Despite nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark.
AB - Aims: Our aim was to investigate whether there is social inequality in access to invasive examination and treatment, and whether access explains social inequality in case fatality in a nationwide sample of patients admitted for the first time with unstable angina or non-ST-elevation myocardial infarction (NSTEMI) in Denmark.Methods and results: All patients admitted for the first time with NSTEMI (n=16,625) or unstable angina (n=8,800) from 2001 to 2009 in Denmark were included. We measured time from admission to coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The outcomes were 30-day and one-year case fatality. We found social inequality in access to CAG and one-year case fatality for both NSTEMI and unstable angina patients, but the time waited for CAG did not explain the social inequality in case fatality.Conclusions: Despite nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark.
KW - acute coronary syndrome
KW - case fatality
KW - social inequality
KW - socioeconomic
KW - time waited
U2 - 10.4244/EIJY15M09_06
DO - 10.4244/EIJY15M09_06
M3 - Journal article
C2 - 26348677
VL - 11
SP - 1495
EP - 1502
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 13
ER -
ID: 162607083