title: The impact of socio-economic status on all-cause mortality after percutaneous coronary intervention: an observational cohort study of 13,770 patients.
abstract: OBJECTIVE
  The relation between socio-economic status (SES) and outcomes after percutaneous coronary intervention (PCI) has not been established. We sought to determine whether or not socio-economic status impacts on prognosis after PCI.
  
  
  RESULTS
  This was an observational cohort study of 13,770 consecutive patients who underwent PCI at a single centre between 2005 and 2011. Patient socio-economic status was defined by the English Index of Multiple Deprivation (IMD) score, according to residential postcode. Patients were analysed by quintile of IMD score (Q1, least deprived; Q5, most deprived). Median follow-up was 3.7 (IQR: 2.0-5.1) years and the primary outcome was all-cause mortality. Patients in Q5 (most deprived) were younger, more commonly South Asian, and had higher rates of smoking, diabetes mellitus, renal impairment, previous MI, and previous PCI than patients in Q1. Rates of long-term mortality increased progressively across the five quintiles of IMD score in a linear fashion (p=0.0004), as did rates of recurrent MI, target vessel revascularisation, and CABG. The difference in mortality rates persisted after adjustment for other potential confounding factors after multivariate analysis (Q5 vs. Q1: HR 1.93, 95% CI: 1.38-2.69).
  
  
  CONCLUSIONS
  In this large contemporary cohort of patients receiving PCI, socio-economic status was associated with prognosis in a linear fashion.
authors.affiliation: Department of Cardiology, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Jones
authors.forename: James P
authors.initials: JP
authors.lastname: Howard
authors.forename: Krishnaraj S
authors.initials: KS
authors.lastname: Rathod
authors.forename: Sean M
authors.initials: SM
authors.lastname: Gallagher
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Knight
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Jain
authors.forename: Anthony
authors.initials: A
authors.lastname: Mathur
authors.forename: Saidi A
authors.initials: SA
authors.lastname: Mohiddin
authors.forename: Peter G
authors.initials: PG
authors.lastname: Mills
authors.forename: Adam D
authors.initials: AD
authors.lastname: Timmis
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Archbold
authors.forename: Andrew
authors.initials: A
authors.lastname: Wragg
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000601:surgery*; D000368:Aged; D060050:Angina, Stable / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008131:London; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D012923:Social Class; D013223:Statistics as Topic; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology