Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?

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Solvej Mårtensson, Dorte Gyrd-Hansen, Eva Prescott, Per Kragh Andersen, Gunnar Gislason, Rikke Kart Jacobsen, Merete Osler

Aims: Our aim was to investigate whether there is social inequality in access to invasive examination and treatment, and whether access explains social inequality in case fatality in a nationwide sample of patients admitted for the first time with unstable angina or non-ST-elevation myocardial infarction (NSTEMI) in Denmark.

Methods and results: All patients admitted for the first time with NSTEMI (n=16,625) or unstable angina (n=8,800) from 2001 to 2009 in Denmark were included. We measured time from admission to coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The outcomes were 30-day and one-year case fatality. We found social inequality in access to CAG and one-year case fatality for both NSTEMI and unstable angina patients, but the time waited for CAG did not explain the social inequality in case fatality.

Conclusions: Despite nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark.
Original languageEnglish
JournalEuroIntervention
Volume11
Issue number13
Pages (from-to)1495-1502
Number of pages8
ISSN1774-024X
DOIs
Publication statusPublished - 20 Apr 2016

    Research areas

  • acute coronary syndrome, case fatality, social inequality, socioeconomic, time waited

ID: 162607083