title: Vital exhaustion in coronary heart disease: the impact of socioeconomic status.
abstract: BACKGROUND
  Vital exhaustion has been shown to be a significant risk factor contributing to coronary heart disease, as well as a predictor of a worse prognosis among coronary patients. Socioeconomic differences in vital exhaustion may be part of the causal mechanism in the health and mortality inequalities connected with socioeconomic disadvantage. Our aim was to explore socioeconomic inequalities in vital exhaustion among coronary patients.
  
  
  METHODS
  We included 362 patients (32% women, mean age 56+/-7.3 years) who were referred for coronary angiography. The Maastricht interview for vital exhaustion was conducted with each patient. Level of income and education were used as indicators of socioeconomic status. Functional status was assessed with the NYHA (dyspnoe symptoms) and CCS (chest pain) scales.
  
  
  RESULTS
  Logistic regression showed significant socioeconomic inequalities in vital exhaustion among patients. Participants with low and middle income and education had a higher probability of being exhausted in comparison with patients with high income and education [odds ratio (95% confidence interval): 13.31 (4.67-37.94) and 2.10 (1.19-3.64), respectively]. Associations remained statistically significant after controlling for the effect of functional status and seriousness of disease. Socioeconomic differences were more salient among men than among women.
  
  
  CONCLUSIONS
  Low education and income seem to be strongly associated with higher vital exhaustion among patients; a significant factor contributing to worse prognosis and lower quality of life among patients with coronary heart disease.
authors.affiliation: Faculty of Arts, Department of Educational and Health Psychology, University of PJ Safarik, Moyzesova 16, Kosice 04001, Slovakia. zuzana.skodova@upjs.sk
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Skodova
authors.forename: Iveta
authors.initials: I
authors.lastname: Nagyova
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Rosenberger
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
authors.forename: Berrie
authors.initials: B
authors.lastname: Middel
authors.forename: Helena
authors.initials: H
authors.lastname: Vargova
authors.forename: Adriana
authors.initials: A
authors.lastname: Sudzinova
authors.forename: Martin
authors.initials: M
authors.lastname: Studencan
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld