Lower incomes may mean lower survival after a heart attack

By Kara Murez
HealthDay reporter

MONDAY, May 23, 2022 (HealthDay News) – If you are poor, you have a severe type heart attackNew research shows that the chances of you living on it are significantly lower than the chances of having more money.

Finding: Stresses the need to close the health care divide that is hitting low-income people hard, says lead researcher Dr. Abdul Manan Khan Minhas, who is hospitalized at the Hatsburg Hospital in Mississippi.

“A lot of work is being done in this area, but obviously, as many studies have shown, much more needs to be done,” he said.

The type of myocardial infarction that his team studied is ST-elevation myocardial infarction, also known as STEMI.

STEMI, which mainly affects heart:The lower extremities may be more severe and dangerous than other types of heart attack.

For the study, researchers analyzed the U.S. Adult Database, which diagnosed STEMI from 2016 to 2018, distributing patients by zip code to measure household income. They also created models that helped compare patient outcomes.

There were a total of 639,300 STEMI hospitalizations, with about 35% of patients in the lowest income category. About 19% were in the high-income group.

The poorest patients had the highest mortality rate of all causes – 11.8%, compared with 10.4% in the high-income group, the study found. They also spent longer in the hospital, more invasive mechanical ventilation.

However, the amount spent on their care was less – about $ 26,503, for a high-income group – $ 30,540, the researchers said.

Although they were more likely to die, poor patients were on average almost two years younger than their wealthy counterparts (63.5 years versus 65.7).

They were also more likely to be women, single, Hispanic, or Native American. Most importantly, they had more than one illness or disease.

“They were sicker from the beginning,” Minhas said. “For example, these patients were more chronic lung diseasemore: [high blood pressure]more diabetes, more Heart failuremore: alcohol/drug/cigarettes abuse և more previous history stroke compared with the other group of patients. That’s probably the most important factor they could have imagined contributing to this inequality. “

At the same time, these low-income patients are also less likely to have them health insurance.

Previous studies have shown that social factors have a great influence on the outcome of the disease. The so-called social determinants of health are “the environment in which people are born, live, study, work, play, worship and grow old,” according to the US Department of Health and Human Services. These may include things like safe housing, racism, job opportunities, access to healthy food, air quality, and income.

Low economic status is associated with worse clinical outcomes of heart disease as well as other health conditions.

Dr. Thriston Smith, director of cardiovascular services at Trinity Health System in Stevenville, Ohio, reviewed the findings.

“The first impression I get is that this is an astonishing charge against the health care system we have, where these inequalities are life-and-death situations based solely on our own revenue-postal index,” he said. “I think there is a lot to open up here, but at face value, this does not look good in terms of how we care for our heart attack patients.”

Several factors probably contribute to these results, Smith said. For one thing, poor patients tend to be at a disadvantage during their lifetime because of co-existing conditions, he said.

“Even if individuals in each group have the same medical conditions as diabetes, those who are poorer may not be able to afford medication control,” Smith said.

“The other issue I saw here, which was very worrying to me, was the cost of the care provided,” Smith said. Even though the poorest patients had higher mortality rates, less was spent on their care.

“It’s a paradox that we need to delve into, because we risk endangering the care of patients in low socioeconomic groups by offering them less effective treatments.” Smith said.

The findings were presented at a meeting of the Society of Cardiovascular Angiography and Interventions in Atlanta on Wednesday. The summary was published earlier Journal of the Association of Cardiovascular Angiography: Interventions.

The results presented during the meetings are considered preliminary until they are published in the peer-reviewed journal.

Research author Minhas says policy-public health efforts are needed to address the problem.

“They should be aimed at alleviating these inequalities, and centralized public health interventions should address socio-economic inequalities,” he said.

In addition, research should examine these differences in access to care.

“We need to have more prospective population-based studies, more robust research projects to help us question these effects of socio-economic inequalities, such as income, education, and everything else, on cardiovascular outcomes,” Minhas said.

Additional information:

The American Heart Association has more to say about heart attack.

SOURCES: Abdul Manan Khan Minhas, doctor, hospital, hospital care service of Hatisburg clinic, Hatisburg, young lady. Thriston Smith, Physician, Medical Director, Cardiology, Archelian Ohio Regional Hospital, Martins Ferry, Ohio; abstract only Journal of the Society of Cardiovascular Angiographyy տ interventions, May 1, 2022 Meeting of the Association of Cardiovascular Angiography, May 18, 2022

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