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Educational inequalities in receiving PCI are influenced by patient's age: A CVDNOR project

Session Poster Session III - Friday 08:30 - 12:30

Speaker Enxhela Llanaj Sulo

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Lipids
  • Session type : Poster Session

Authors : E Sulo (Bergen,NO), O Nygard (Bergen,NO), SE Vollset (Bergen,NO), G Sulo (Bergen,NO), J Igland (Bergen,NO), G Egeland (Bergen,NO), M Ebbing (Bergen,NO), GS Tell (Bergen,NO)

E Sulo1 , O Nygard2 , SE Vollset1 , G Sulo1 , J Igland1 , G Egeland3 , M Ebbing3 , GS Tell1 , 1University of Bergen, Department of Global Public Health and Primary Care - Bergen - Norway , 2Haukeland Hospital, Institute of Medicine, University of Bergen, Department of Heart Disease - Bergen - Norway , 3Norwegian Institute of Public Health, Department of Health Registries - Bergen - Norway ,


Purpose – Health outcomes are associated with socioeconomic inequities which are also influenced by in inequities in receiving treatment. We aimed to explore possible educational inequities in receiving percutaneous coronary intervention (PCI) among patients with an incident (first) acute myocardial infarction (AMI) and whether inequities vary by age.

Methods – All hospitalized AMI patients aged 35-89 years in Norway during 2001-2009 were obtained from the Cardiovascular Disease in Norway project. Information on highest attained education was obtained from The Norwegian Education Database and categorized into primary, secondary and tertiary. Educational inequities in receiving PCI were explored using Poisson regression analysis. An interaction between age and education was found (p<0.01), analyses were therefore stratified by age.  Results are expressed as relative risk (RR) and 95% CI of receiving PCI treatment for secondary or tertiary versus primary (reference category) education.

Results – Of 104,836 patients hospitalized with an incident AMI [mean age (SD) 71.1 (12.7) years; 37.3% women), 30.2% received PCI within 28 days. Overall, patients with secondary or tertiary education had higher rates of PCI compared to those with primary education only [RR=1.12, 95% CI; 1.10 - 1.14 and RR=1.21, 95% CI; 1.17 - 1.24, respectively]. Educational inequities (both for secondary versus primary and tertiary versus primary comparisons) were associated  with increasing age.

Conclusion – Middle-aged and elderly patients with secondary or tertiary education had higher PCI rates compared to those with primary education only. Further studies should evaluate whether such differences are explained by differences in risk factors and disease severity.

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