کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5978169 1576247 2012 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Socioeconomic risk factor aggregation and long-term incidence of ischemic stroke in patients after first acute myocardial infarction
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Socioeconomic risk factor aggregation and long-term incidence of ischemic stroke in patients after first acute myocardial infarction
چکیده انگلیسی

BackgroundLow socioeconomic status (SES) has been associated with increased cardiovascular risk. However, the association between SES and stroke incidence in patients with acute myocardial infarction (AMI) has not been studied. We assessed the association between a multidimensional SES construct and long-term ischemic stroke incidence after AMI in a prospective community-based cohort study.MethodsA total of 1261 consecutive patients aged ≤ 65 years discharged after first AMI from 8 hospitals in central Israel in 1992-1993 were followed for ischemic stroke for a mean (SD) period of 11 (4) years. The number of unfavorable SES factors, including lower than average family income, ≤ 8 years of education, unemployment, and absence of a steady partner, was the primary exposure. We estimated the directly adjusted cumulative incidence of stroke treating non-stroke death as a competing event using the Fine and Gray model for a subdistribution function.ResultsLow SES was associated with older age, female sex, higher risk factor prevalence, increased AMI severity and inferior treatment. Ischemic stroke was diagnosed in 142 patients. The adjusted cumulative incidence of ischemic stroke gradually increased with the number of unfavorable SES factors. The multivariable adjusted HRs (95% confidence intervals) for ischemic stroke were 1.5(0.9-2.4), 2.0(1.2-3.2) and 2.1(1.2-3.6) in patients with 1, 2 and ≥ 3 unfavorable SES factors respectively, compared with those with none.ConclusionsOur data support a dose-response relationship between SES and stroke risk after AMI and suggest a multidimensional vulnerability related to SES. These findings should be considered in planning secondary prevention strategies post-AMI.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 157, Issue 3, 14 June 2012, Pages 324-329
نویسندگان
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