Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.

Socioeconomic status and gender are associated with access to cardiac procedures and mortality after AMI, also in countries with universal health care systems. Our objective was to evaluate the association and trends of educational level or gender and the following outcomes: 1) access to PTCA; 2) 30...

Full description

Bibliographic Details
Main Authors: Laura Cacciani, Nera Agabiti, Anna Maria Bargagli, Marina Davoli
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5383153?pdf=render
_version_ 1819210999337582592
author Laura Cacciani
Nera Agabiti
Anna Maria Bargagli
Marina Davoli
author_facet Laura Cacciani
Nera Agabiti
Anna Maria Bargagli
Marina Davoli
author_sort Laura Cacciani
collection DOAJ
description Socioeconomic status and gender are associated with access to cardiac procedures and mortality after AMI, also in countries with universal health care systems. Our objective was to evaluate the association and trends of educational level or gender and the following outcomes: 1) access to PTCA; 2) 30-day mortality.We conducted an observational study based on 14,013 subjects aged 35-74 years, residing in Rome in 2001, and hospitalised for incident STEMI within 2012 in the Lazio region. We estimated adjusted ORs of educational level or gender and: 1) PTCA within 2 days after hospitalisation, 2) 30-day mortality. We evaluated time trends of outcomes, and time trends of educational or gender differentials estimating ORs stratified by time period (two time periods between 2001 and 2012). We performed a hierarchical analysis to account for clustering of hospitals.Access to PTCA among patients with incident STEMI increased during the study period, while 30-day mortality was stable. We observed educational differentials in PTCA procedure only in the first time period, and gender differentials in both periods. Patterns for 30-day mortality were less marked, with educational differentials emerging only in the second period, and gender differentials only in the first one, with patients with low educational level and females being disadvantaged.Educational differentials in the access to PTCA disappeared in Lazio region over time, coherently with scientific literature, while gender differentials seem to persist. It may be important to assess the role of female gender in patients with STEMI, both from a social and a clinical point of view.
first_indexed 2024-12-23T06:20:06Z
format Article
id doaj.art-30e3b0ab1e904e3cb7f2de1acbdcbc0a
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-23T06:20:06Z
publishDate 2017-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-30e3b0ab1e904e3cb7f2de1acbdcbc0a2022-12-21T17:57:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01124e017503810.1371/journal.pone.0175038Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.Laura CaccianiNera AgabitiAnna Maria BargagliMarina DavoliSocioeconomic status and gender are associated with access to cardiac procedures and mortality after AMI, also in countries with universal health care systems. Our objective was to evaluate the association and trends of educational level or gender and the following outcomes: 1) access to PTCA; 2) 30-day mortality.We conducted an observational study based on 14,013 subjects aged 35-74 years, residing in Rome in 2001, and hospitalised for incident STEMI within 2012 in the Lazio region. We estimated adjusted ORs of educational level or gender and: 1) PTCA within 2 days after hospitalisation, 2) 30-day mortality. We evaluated time trends of outcomes, and time trends of educational or gender differentials estimating ORs stratified by time period (two time periods between 2001 and 2012). We performed a hierarchical analysis to account for clustering of hospitals.Access to PTCA among patients with incident STEMI increased during the study period, while 30-day mortality was stable. We observed educational differentials in PTCA procedure only in the first time period, and gender differentials in both periods. Patterns for 30-day mortality were less marked, with educational differentials emerging only in the second period, and gender differentials only in the first one, with patients with low educational level and females being disadvantaged.Educational differentials in the access to PTCA disappeared in Lazio region over time, coherently with scientific literature, while gender differentials seem to persist. It may be important to assess the role of female gender in patients with STEMI, both from a social and a clinical point of view.http://europepmc.org/articles/PMC5383153?pdf=render
spellingShingle Laura Cacciani
Nera Agabiti
Anna Maria Bargagli
Marina Davoli
Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.
PLoS ONE
title Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.
title_full Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.
title_fullStr Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.
title_full_unstemmed Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.
title_short Access to percutaneous transluminal coronary angioplasty and 30-day mortality in patients with incident STEMI: Differentials by educational level and gender over 11 years.
title_sort access to percutaneous transluminal coronary angioplasty and 30 day mortality in patients with incident stemi differentials by educational level and gender over 11 years
url http://europepmc.org/articles/PMC5383153?pdf=render
work_keys_str_mv AT lauracacciani accesstopercutaneoustransluminalcoronaryangioplastyand30daymortalityinpatientswithincidentstemidifferentialsbyeducationallevelandgenderover11years
AT neraagabiti accesstopercutaneoustransluminalcoronaryangioplastyand30daymortalityinpatientswithincidentstemidifferentialsbyeducationallevelandgenderover11years
AT annamariabargagli accesstopercutaneoustransluminalcoronaryangioplastyand30daymortalityinpatientswithincidentstemidifferentialsbyeducationallevelandgenderover11years
AT marinadavoli accesstopercutaneoustransluminalcoronaryangioplastyand30daymortalityinpatientswithincidentstemidifferentialsbyeducationallevelandgenderover11years