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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2014

Open Access 01-12-2014 | Research

Long-term survival among older patients with myocardial infarction differs by educational level: results from the MONICA/KORA myocardial infarction registry

Authors: Inge Kirchberger, Christa Meisinger, Hildegard Golüke, Margit Heier, Bernhard Kuch, Annette Peters, Philip A Quinones, Wolfgang von Scheidt, Andreas Mielck

Published in: International Journal for Equity in Health | Issue 1/2014

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Abstract

Background

Socioeconomic disparities in survival after acute myocardial infarction (AMI) have been found in many countries. However, population-based results from Germany are lacking so far. Thus, the objective of this study was to examine the association between educational status and long-term mortality in a population-based sample of people with AMI.

Methods

The sample consisted of 2,575 men and 844 women, aged 28–74 years, hospitalized with a first-time AMI between 1 January 2000 and 31 December 2008, recruited from a population-based AMI registry. Patients were followed up until December 2011. Data on education, risk factors and co-morbidities were collected by individual interviews; data on clinical characteristics and AMI treatment by chart review. Cox proportional hazards models were used to assess the relationship between educational status and long-term mortality.

Results

During follow-up, 19.1% of the patients with poor education died compared with 13.1% with higher education. After adjustment for covariates, no effect of education on mortality was found for the total sample and for patients aged below 65 years. In older people, however, low education level was significantly associated with increased mortality (hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.05–1.98, p = 0.023). Stratified analyses showed that women older than 64 years with poor education were significantly more likely to die than women in the same age group with higher education (HR 1.57, 95% CI 1.02–2.41, p = 0.039).

Conclusions

Elderly, poorly educated patients with AMI, and particularly women, have poorer long-term survival than their better educated peers. Further research is required to illuminate the reasons for this finding.
Appendix
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Metadata
Title
Long-term survival among older patients with myocardial infarction differs by educational level: results from the MONICA/KORA myocardial infarction registry
Authors
Inge Kirchberger
Christa Meisinger
Hildegard Golüke
Margit Heier
Bernhard Kuch
Annette Peters
Philip A Quinones
Wolfgang von Scheidt
Andreas Mielck
Publication date
01-12-2014
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2014
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-13-19

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