Mortality after acute myocardial infarction according to income and education

Jeppe N Rasmussen, Søren Rasmussen, Gunnar H Gislason, Pernille Buch, Steen Z Abildstrom, Lars Køber, Merete Osler, Finn Diderichsen, Christian Torp-Pedersen, Mette Madsen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI in Denmark in 1995-2002. MAIN OUTCOME MEASURES: Relative risk (RR) of 30 day mortality and long term mortality (31 days until 31 December 2003) associated with income (adjusted for education) or educational level (adjusted for income) and further adjusted for sex, age, civil status, and comorbidity. RESULTS: The study identified 21 391 patients 30-64 years old and 16 169 patients 65-74 years old. The 30 day mortality was 7.0% among patients 30-64 years old and 15.9% among those 65-74 years old. Among patients surviving the first 30 days, the long term mortality was 9.9% and 28.3%, respectively. The adjusted RR of 30 day mortality and long term mortality among younger patients with low compared with high income was 1.54 (95% confidence interval 1.36 to 1.79) and 1.65 (1.45 to 1.85), respectively. The RR of 30 day and long term mortality among younger patients with low compared with high education was 1.24 (1.03 to 1.50) and 1.33 (1.11 to 1.59), respectively. The RR of 30 day and long term mortality among older patients with low compared with high income was 1.27 (1.15 to 1.41) and 1.38 (1.27 to 1.50), respectively. Older high and low education patients did not differ in mortality. CONCLUSION: This study shows that both educational level and income substantially and independently affect mortality after AMI, indicating that each indicator has specific effects on mortality and that these indicators are not interchangeable.
Original languageEnglish
JournalJournal of Epidemiology & Community Health
Volume60
Issue number4
Pages (from-to)351-6
Number of pages5
ISSN0143-005X
DOIs
Publication statusPublished - 1. Apr 2006

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Education
Denmark
Patient Education
Registries
Comorbidity
Outcome Assessment (Health Care)
Confidence Intervals

Keywords

  • Acute Disease
  • Adult
  • Aged
  • Denmark
  • Educational Status
  • Female
  • Hospital Mortality
  • Humans
  • Income
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Proportional Hazards Models
  • Prospective Studies

Cite this

Rasmussen, J. N., Rasmussen, S., Gislason, G. H., Buch, P., Abildstrom, S. Z., Køber, L., ... Madsen, M. (2006). Mortality after acute myocardial infarction according to income and education. Journal of Epidemiology & Community Health, 60(4), 351-6. https://doi.org/10.1136/jech.200X.040972
Rasmussen, Jeppe N ; Rasmussen, Søren ; Gislason, Gunnar H ; Buch, Pernille ; Abildstrom, Steen Z ; Køber, Lars ; Osler, Merete ; Diderichsen, Finn ; Torp-Pedersen, Christian ; Madsen, Mette. / Mortality after acute myocardial infarction according to income and education. In: Journal of Epidemiology & Community Health. 2006 ; Vol. 60, No. 4. pp. 351-6.
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abstract = "OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI in Denmark in 1995-2002. MAIN OUTCOME MEASURES: Relative risk (RR) of 30 day mortality and long term mortality (31 days until 31 December 2003) associated with income (adjusted for education) or educational level (adjusted for income) and further adjusted for sex, age, civil status, and comorbidity. RESULTS: The study identified 21 391 patients 30-64 years old and 16 169 patients 65-74 years old. The 30 day mortality was 7.0{\%} among patients 30-64 years old and 15.9{\%} among those 65-74 years old. Among patients surviving the first 30 days, the long term mortality was 9.9{\%} and 28.3{\%}, respectively. The adjusted RR of 30 day mortality and long term mortality among younger patients with low compared with high income was 1.54 (95{\%} confidence interval 1.36 to 1.79) and 1.65 (1.45 to 1.85), respectively. The RR of 30 day and long term mortality among younger patients with low compared with high education was 1.24 (1.03 to 1.50) and 1.33 (1.11 to 1.59), respectively. The RR of 30 day and long term mortality among older patients with low compared with high income was 1.27 (1.15 to 1.41) and 1.38 (1.27 to 1.50), respectively. Older high and low education patients did not differ in mortality. CONCLUSION: This study shows that both educational level and income substantially and independently affect mortality after AMI, indicating that each indicator has specific effects on mortality and that these indicators are not interchangeable.",
keywords = "Acute Disease, Adult, Aged, Denmark, Educational Status, Female, Hospital Mortality, Humans, Income, Male, Middle Aged, Myocardial Infarction, Proportional Hazards Models, Prospective Studies",
author = "Rasmussen, {Jeppe N} and S{\o}ren Rasmussen and Gislason, {Gunnar H} and Pernille Buch and Abildstrom, {Steen Z} and Lars K{\o}ber and Merete Osler and Finn Diderichsen and Christian Torp-Pedersen and Mette Madsen",
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Rasmussen, JN, Rasmussen, S, Gislason, GH, Buch, P, Abildstrom, SZ, Køber, L, Osler, M, Diderichsen, F, Torp-Pedersen, C & Madsen, M 2006, 'Mortality after acute myocardial infarction according to income and education', Journal of Epidemiology & Community Health, vol. 60, no. 4, pp. 351-6. https://doi.org/10.1136/jech.200X.040972

Mortality after acute myocardial infarction according to income and education. / Rasmussen, Jeppe N; Rasmussen, Søren; Gislason, Gunnar H; Buch, Pernille; Abildstrom, Steen Z; Køber, Lars; Osler, Merete; Diderichsen, Finn; Torp-Pedersen, Christian; Madsen, Mette.

In: Journal of Epidemiology & Community Health, Vol. 60, No. 4, 01.04.2006, p. 351-6.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Mortality after acute myocardial infarction according to income and education

AU - Rasmussen, Jeppe N

AU - Rasmussen, Søren

AU - Gislason, Gunnar H

AU - Buch, Pernille

AU - Abildstrom, Steen Z

AU - Køber, Lars

AU - Osler, Merete

AU - Diderichsen, Finn

AU - Torp-Pedersen, Christian

AU - Madsen, Mette

PY - 2006/4/1

Y1 - 2006/4/1

N2 - OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI in Denmark in 1995-2002. MAIN OUTCOME MEASURES: Relative risk (RR) of 30 day mortality and long term mortality (31 days until 31 December 2003) associated with income (adjusted for education) or educational level (adjusted for income) and further adjusted for sex, age, civil status, and comorbidity. RESULTS: The study identified 21 391 patients 30-64 years old and 16 169 patients 65-74 years old. The 30 day mortality was 7.0% among patients 30-64 years old and 15.9% among those 65-74 years old. Among patients surviving the first 30 days, the long term mortality was 9.9% and 28.3%, respectively. The adjusted RR of 30 day mortality and long term mortality among younger patients with low compared with high income was 1.54 (95% confidence interval 1.36 to 1.79) and 1.65 (1.45 to 1.85), respectively. The RR of 30 day and long term mortality among younger patients with low compared with high education was 1.24 (1.03 to 1.50) and 1.33 (1.11 to 1.59), respectively. The RR of 30 day and long term mortality among older patients with low compared with high income was 1.27 (1.15 to 1.41) and 1.38 (1.27 to 1.50), respectively. Older high and low education patients did not differ in mortality. CONCLUSION: This study shows that both educational level and income substantially and independently affect mortality after AMI, indicating that each indicator has specific effects on mortality and that these indicators are not interchangeable.

AB - OBJECTIVE: To study how income and educational level influence mortality after acute myocardial infarction (AMI). DESIGN AND SETTING: Prospective analysis using individual level linkage of registries in Denmark. PARTICIPANTS: All patients 30-74 years old hospitalised for the first time with AMI in Denmark in 1995-2002. MAIN OUTCOME MEASURES: Relative risk (RR) of 30 day mortality and long term mortality (31 days until 31 December 2003) associated with income (adjusted for education) or educational level (adjusted for income) and further adjusted for sex, age, civil status, and comorbidity. RESULTS: The study identified 21 391 patients 30-64 years old and 16 169 patients 65-74 years old. The 30 day mortality was 7.0% among patients 30-64 years old and 15.9% among those 65-74 years old. Among patients surviving the first 30 days, the long term mortality was 9.9% and 28.3%, respectively. The adjusted RR of 30 day mortality and long term mortality among younger patients with low compared with high income was 1.54 (95% confidence interval 1.36 to 1.79) and 1.65 (1.45 to 1.85), respectively. The RR of 30 day and long term mortality among younger patients with low compared with high education was 1.24 (1.03 to 1.50) and 1.33 (1.11 to 1.59), respectively. The RR of 30 day and long term mortality among older patients with low compared with high income was 1.27 (1.15 to 1.41) and 1.38 (1.27 to 1.50), respectively. Older high and low education patients did not differ in mortality. CONCLUSION: This study shows that both educational level and income substantially and independently affect mortality after AMI, indicating that each indicator has specific effects on mortality and that these indicators are not interchangeable.

KW - Acute Disease

KW - Adult

KW - Aged

KW - Denmark

KW - Educational Status

KW - Female

KW - Hospital Mortality

KW - Humans

KW - Income

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Proportional Hazards Models

KW - Prospective Studies

U2 - 10.1136/jech.200X.040972

DO - 10.1136/jech.200X.040972

M3 - Journal article

VL - 60

SP - 351

EP - 356

JO - Journal of Epidemiology & Community Health

JF - Journal of Epidemiology & Community Health

SN - 0143-005X

IS - 4

ER -

Rasmussen JN, Rasmussen S, Gislason GH, Buch P, Abildstrom SZ, Køber L et al. Mortality after acute myocardial infarction according to income and education. Journal of Epidemiology & Community Health. 2006 Apr 1;60(4):351-6. https://doi.org/10.1136/jech.200X.040972