Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012

Background: Socioeconomic status is associated with cardiovascular mortality. Aim: To evaluate the effect of educational level, on the prognosis of patients with acute myocardial infarction in Chile. Material and Methods: Cohort study of 3,636 patients aged 63.1 ± 13.2 years, 27% women, hospitalized...

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Autores principales:	Nazzal,Carolina, Corbalán,Ramón, Díaz,Claudia, Sepúlveda,Pablo, Schacht,Eliana
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2015
Materias:	Acute myocardial infarction Educational status Latin America Social class Survival
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015000700001
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spelling	oai:scielo:S0034-988720150007000012015-09-03Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012Nazzal,CarolinaCorbalán,RamónDíaz,ClaudiaSepúlveda,PabloSchacht,Eliana Acute myocardial infarction Educational status Latin America Social class Survival Background: Socioeconomic status is associated with cardiovascular mortality. Aim: To evaluate the effect of educational level, on the prognosis of patients with acute myocardial infarction in Chile. Material and Methods: Cohort study of 3,636 patients aged 63.1 ± 13.2 years, 27% women, hospitalized in 16 centers participating in the Chilean Myocardial Infarction Registry (GEMI) between 2009 and 2012. Vital status was obtained from the National Mortality Database. Patients were divided, according to educational level, in four groups, namely none (no formal education), basic (< 8 years), secondary (8-12 years) and tertiary (> 12 years). Crude and adjusted (age, sex, cardiovascular risk factors and treatments) hazard ratios (HR) were estimated using Cox regression models. Results: The distribution by educational level was 3.2% none, 31.8% basic, 43.0% secondary and 22.0% tertiary. During a median follow-up period of 22 months (interquartile range 11-37 years), 631 patients died (17.3%), of whom 198 died during hospitalization (5.5%). The 30 day case-fatality rate according to educational level was 3.4% in tertiary, 4.7% in secondary, 11.9% in basic, 19.1% in none (p < 0.0001). Among patients surviving the first 30 days, the case-fatality rate was 4.4%, 8.6%, 14.6% and 27.0%, respectively (p < 0.0001). The increased risk of death for groups with lower education compared with individuals with tertiary education, persisted in the multivariate analysis with a hazard ratio for secondary education 1.58 (95% confidence intervals (CI), 1.18-2.10); for basic education 1.90 (95% CI, 1.41-2.47) and for none 3.50 (95% CI, 2.35-5.21). Conclusions: A lower educational level was associated with a worse prognosis in patients with myocardial infarction, even after controlling for potential confounding factors.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.143 n.7 20152015-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015000700001es10.4067/S0034-98872015000700001
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acute myocardial infarction Educational status Latin America Social class Survival
spellingShingle	Acute myocardial infarction Educational status Latin America Social class Survival Nazzal,Carolina Corbalán,Ramón Díaz,Claudia Sepúlveda,Pablo Schacht,Eliana Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012
description	Background: Socioeconomic status is associated with cardiovascular mortality. Aim: To evaluate the effect of educational level, on the prognosis of patients with acute myocardial infarction in Chile. Material and Methods: Cohort study of 3,636 patients aged 63.1 ± 13.2 years, 27% women, hospitalized in 16 centers participating in the Chilean Myocardial Infarction Registry (GEMI) between 2009 and 2012. Vital status was obtained from the National Mortality Database. Patients were divided, according to educational level, in four groups, namely none (no formal education), basic (< 8 years), secondary (8-12 years) and tertiary (> 12 years). Crude and adjusted (age, sex, cardiovascular risk factors and treatments) hazard ratios (HR) were estimated using Cox regression models. Results: The distribution by educational level was 3.2% none, 31.8% basic, 43.0% secondary and 22.0% tertiary. During a median follow-up period of 22 months (interquartile range 11-37 years), 631 patients died (17.3%), of whom 198 died during hospitalization (5.5%). The 30 day case-fatality rate according to educational level was 3.4% in tertiary, 4.7% in secondary, 11.9% in basic, 19.1% in none (p < 0.0001). Among patients surviving the first 30 days, the case-fatality rate was 4.4%, 8.6%, 14.6% and 27.0%, respectively (p < 0.0001). The increased risk of death for groups with lower education compared with individuals with tertiary education, persisted in the multivariate analysis with a hazard ratio for secondary education 1.58 (95% confidence intervals (CI), 1.18-2.10); for basic education 1.90 (95% CI, 1.41-2.47) and for none 3.50 (95% CI, 2.35-5.21). Conclusions: A lower educational level was associated with a worse prognosis in patients with myocardial infarction, even after controlling for potential confounding factors.
author	Nazzal,Carolina Corbalán,Ramón Díaz,Claudia Sepúlveda,Pablo Schacht,Eliana
author_facet	Nazzal,Carolina Corbalán,Ramón Díaz,Claudia Sepúlveda,Pablo Schacht,Eliana
author_sort	Nazzal,Carolina
title	Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012
title_short	Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012
title_full	Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012
title_fullStr	Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012
title_full_unstemmed	Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012
title_sort	efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: registro chileno de infarto de miocardio, gemi 2009-2012
publisher	Sociedad Médica de Santiago
publishDate	2015
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015000700001
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Efecto del nivel educacional en la sobrevida posterior a un infarto agudo de miocardio: Registro Chileno de Infarto de Miocardio, GEMI 2009-2012

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