Coronary disease & ACS

Differences in Treatment Patterns and Outcomes of Acute Myocardial Infarction for Low- and High-Income Patients in 6 Countries

JAMAPublished Serial cross-sectional cohort study

Main finding · Mortality (30-day and 1-year)Result — go to the resultDifference −2.8 percentage points 95% CI −4.1 to −1.5

Authors' conclusion

High-income individuals had substantially better survival and were more likely to receive lifesaving revascularization and had shorter hospital lengths of stay and fewer readmissions across almost all countries.

Study context

Population
Adults aged ≥66 years hospitalized with acute MI, 2013–2018, in the US, Canada, England, the Netherlands, Taiwan and Israel
Exposure
High-income vs low-income patients
Outcome
30-day and 1-year mortality
Methodological detailspopulation-representative administrative data, 6 countries
  • Population-representative administrative data
  • 6 countries

Main finding

Mortality (30-day and 1-year)

Difference

−2.8 percentage points

95% CI −4.1 to −1.5

High incomevs Low income
difference −2.8 percentage points (95% CI −4.1 to −1.5)

As reported in the abstract

1-year mortality, STEMI, Israel (largest difference): 16.2% vs 25.3%
−9.1 percentage points (95% CI, −16.7 to −1.6)

Observational data: associations, not effects.

Secondary outcomes

OutcomeHigh incomeLow incomeDifference (percentage points) (95% CI)
Cardiac catheterization and PCIPCI, STEMI, England73.6%67.4%6.1 (1.2–11.0)
CABGNSTEMI, US12.5%11.0%1.5 (1.3–1.8)
Cardiac catheterization and PCI — Higher among high- vs low-income in all countries; absolute differences
1 to 6 percentage points
CABG — non-STEMI (NSTEMI): generally higher among high-income patients
1 to 2 percentage points

CABG

STEMI: similar in low- vs high-income strata

30-day readmission and length of stay

30-day readmission generally lower for high-income patients
1 to 3 percentage points
Length of stay generally shorter for high-income patients
0.2 to 0.5 days

Original publication

Differences in Treatment Patterns and Outcomes of Acute Myocardial Infarction for Low- and High-Income Patients in 6 Countries. JAMA. Published 4 April 2023. doi:10.1001/jama.2023.1699

Composed by AI from the published abstract and checked against it. How Briefs are made →

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