In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Socioeconomic status; how does it influence referral to cardiac rehabilitation after acute myocardial infarction?

Session Poster Session 1

Speaker Christina Graversen

Event : ESC Congress 2019

  • Topic : preventive cardiology
  • Sub-topic : Cardiovascular Rehabilitation
  • Session type : Poster Session

Authors : CB Graversen (Aalborg,DK), MB Johansen (Aalborg,DK), SP Johnsen (Aalborg,DK), S Riahi (Aalborg,DK), T Holmberg (Copenhagen,DK), ML Larsen (Aalborg,DK)

Authors:
CB Graversen1 , MB Johansen2 , SP Johnsen3 , S Riahi1 , T Holmberg4 , ML Larsen1 , 1Aalborg University Hospital, Cardiology - Aalborg - Denmark , 2Aalborg University Hospital, Unit of Clinical Biostatistics - Aalborg - Denmark , 3Aalborg University, Department of Clinical Medicine - Aalborg - Denmark , 4National Institute of Public Health - Copenhagen - Denmark ,

Citation:

Background: The number of patients with low socioeconomic status who are referred to cardiac rehabilitation (CR) has been documented to be relative lower than patients with high SES among all patients hospitalised with acute myocardial infarction (AMI).

Purpose: The aims of this study were to evaluate the referral process to CR and how it is influenced by socioeconomic variables.

Methods: In 2011-2014, 1229 patients were hospitalised with AMI at Department of Cardiology of our University Hospital, Denmark. All were evaluated for participation to CR. Socioeconomic status was measured by personal income, educational level, marital status, and employment and obtained from national registers. Multiple logistic regression assessed socioeconomic determinants in three phases of the referral process to CR: 1. information about CR, 2. wish to participate in CR, and 3. referral to specialiced- or municipality-based CR. All analyses were adjusted for sex, age, and comorbidities.

Results: A total of 1123 (91.4%) patients received information regarding CR. Of these, 854 (69.5 %) patients wished to participate in the programme. Income was the most important socioeconomic variable when looking at who were informed about CR (OR 2.17, 95%-CI: 1.0- 4.64) and who wished to participate in CR (OR 1.55, 95%-CI: 1.02-2.35).

Conclusion: Two out of three patients received referral to CR. However, higher income was proportional with the likelihood of receiving information about CR and willingness to participate in the programme.

Characteristics

All participants

n = 1229

STEMI

n = 402

NSTEMI

n = 711

UAP

n = 116

Male (n, %) 907 (73.8) 322 (80.1) 503 (70.7) 82 (70.7)

Age Group (yrs)

< 65

65-74

≥75

591 (48.1)

371 (30.2)

267 (21.7)

227 (56.5)

116 (28.9)

59 (14.7)

308 (43.3)

215 (30.2)

188 (26.4)

56 (48.3)

40 (34.5)

20 (17.2)

Baseline Comorbidity

Hypertension

Diabetes

241 (19.6)

14 (1.1)

62 (15.4)

<5 (<1)

148 (20.8)

8 (1.1)

31 (26.7)

<5 (<1)

Charlson Comorbidity Index

Low (0 points)

Moderate/High (>0)

1088 (88.5)

141 (11.5)

358 (89.1)

44 (10.9)

630 (88.6)

81 (11.4)

100 (86.2)

16 (13.8)

Civil status (n, %)

Married/Partnership

Divorced/Unmarried/Widow

793 (64.5)

436 (35.5)

253 (62.9)

149 (37.1)

449 (63.2)

262 (36.8)

91 (78.4)

25 (21.6)

Occupational status (n, %)

Employed

Unemployed/Retired

479 (39.0)

750 (61.0)

195 (48.5)

207 (51.5)

240 (33.8)

471 (66.2)

44 (37.9)

72 (62.1)

Educational status (n, %)

Low

Medium

High

516 (42.0)

539 (43.9)

174 (14.2)

144 (35.8)

201 (50.0)

57 (14.2)

322 (45.3)

293 (41.2)

96 (13.5)

50 (43.1)

45 (38.8)

21 (18.1)

Gross income, tertile (n, %)

Low

Medium

High

405 (33.0)

406 (33.0)

418 (34.0)

113 (28.1)

124 (30.8)

165 (41.0)

251 (35.3)

247 (34.7)

213 (30.0)

41 (35.3)

35 (30.2)

40 (34.5)

STEMI: ST-elevated myocardial infarction; NSTEMI: non-ST-elevated myocardial infarction; UAP: unstable angina pectoris

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are