Influence of socioeconomic status on clinical outcomes and quality of life after percutaneous coronary intervention.
OBJECTIVE
To determine whether socioeconomic status (SES) influences clinical outcomes and quality of life after percutaneous coronary intervention (PCI).


METHODS
Prospective observational study.


METHODS
Two interventional cardiac centres.


METHODS
1346 consecutive patients undergoing PCI over a 12-month period.


RESULTS
Self reported health-related quality of life (HRQoL; EuroQol-5 Dimensions (EQ-5D); EuroQol Visual Analogue Scale (EQ-VAS)), repeat angiography, revascularisation, hospital admission, myocardial infarction and death within 12 months, by SES derived using postal address code.


RESULTS
No significant differences were found between patients with high and low SES in the occurrence of repeat angiography (p = 0.55), repeat revascularisation (PCI, p = 0.81, CAEG, p = 0.27), total cardiac hospitalisation (p = 0.10), myocardial infarction (p = 0.97) or death 12 months after PCI (p = 0.88). Non-procedure-related readmissions were higher in patients with low SES (18.6% v 13.7%; p = 0.025). After adjustment for confounding factors, patients with low SES had lower HRQoL scores at baseline (95% CI for difference 0.01 to 0.14; p = 0.003) and at 12 months (95% CI 0.07 to 0.17; p<0.001) compared with those with high SES.


CONCLUSIONS
Clinical outcomes were similar for patients in different SES groups. Patients with low SES had considerably more non-procedure-related readmissions and lower quality-of-life scores. Future studies on HRQoL after coronary revascularisation should take account of these important differences related to SES.
Denvir
M A
MA
Centre for Cardiovascular Research, University of Edinburgh, Edinburgh, UK. mdenvir@staffmail.ed.ac.uk
Lee
A J
AJ
Rysdale
J
J
Walker
A
A
Eteiba
H
H
Starkey
I R
IR
Pell
J P
JP
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality / Q000523:psychology / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life / Q000523:psychology*; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014850:Waiting Lists