Socioeconomic deprivation and prognostic outcomes in acute coronary syndrome: A meta-analysis using multidimensional socioeconomic status indices

Anand VV 1 , Zhe ELC 1 , Chin YH 2 , Goh RSJ 3 , Lin C 3 , Kueh MTW 4 Show all authors , Chong B 3 , Kong G 3 , Tay PWL 3 , Dalakoti M 5 , Muthiah M 6 , Dimitriadis GK 7 , Wang JW 8 , Mehta A 9 , Foo R 5 , Tse G 10 , Figtree GA 11 , Loh PH 5 , Chan MY 5 , Mamas MA 12 , Chew NWS 13

Affiliations 

  • 1 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  • 2 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore
  • 3 Yong Loo Lin School of Medicine, National University Singapore, Singapore
  • 4 Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Malaysia
  • 5 Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Cardiology, National University Heart Centre, National University Health System, Singapore
  • 6 Yong Loo Lin School of Medicine, National University Singapore, Singapore; Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; National University Centre for Organ Transplantation, National University Health System, Singapore
  • 7 Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK; Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
  • 8 Yong Loo Lin School of Medicine, National University Singapore, Singapore; Department of Surgery, Cardiovascular Research Institute (CVRI), National University of Singapore, Singapore; Nanomedicine Translational Research Programme, Centre for NanoMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 9 Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University Pauley Heart Centre, Richmond, VA, USA
  • 10 Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, China; Kent and Medway Medical School, Kent, Canterbury CT2 7NT, UK; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
  • 11 Northern Clinical School, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia
  • 12 Keele Cardiovascular Research Group, School of Medicine, Keele University, Stoke-on-Trent, UK; Institute of Population Health, University of Manchester, UK
  • 13 Department of Cardiology, National University Heart Centre, National University Health System, Singapore. Electronic address: nicholas_ws_chew@nuhs.edu.sg
Int J Cardiol, 2023 Jul 15;383:140-150.
PMID: 37116760 DOI: 10.1016/j.ijcard.2023.04.042

Abstract

BACKGROUND: Low socioeconomic status (SES) is an important prognosticator amongst patients with acute coronary syndrome (ACS). This paper analysed the effects of SES on ACS outcomes.

METHODS: Medline and Embase were searched for articles reporting outcomes of ACS patients stratified by SES using a multidimensional index, comprising at least 2 of the following components: Income, Education and Employment. A comparative meta-analysis was conducted using random-effects models to estimate the risk ratio of all-cause mortality in low SES vs high SES populations, stratified according to geographical region, study year, follow-up duration and SES index.

RESULTS: A total of 29 studies comprising of 301,340 individuals were included, of whom 43.7% were classified as low SES. While patients of both SES groups had similar cardiovascular risk profiles, ACS patients of low SES had significantly higher risk of all-cause mortality (adjusted HR:1.19, 95%CI: 1.10-1.1.29, p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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