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Treatment after a heart attack varies with educational level

A new study from the Department of Global Public Health and Primary Care (IGS) has shown that patients with lower levels of education were less likely to receive coronary angiography and hence revascularization compared to their counterparts with higher education.

Heart attack
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The CVDNOR project ‘Cardiovascular Disease in Norway’ (CVDNOR) project (PI, prof. Grethe S Tell) was established (www.cvdnor.no ) because Norway did not have a national cardiovascular disease register before 2012.  CVDNOR contains information on all hospitalizations in Norway due to cardiovascular disease or diabetes during 1994-2014. Researchers from UiB used data from CVDNOR to study trends and educational differences in receiving invasive procedures among patients hospitalized with a first acute myocardial infarction (AMI) in Norway during 2001-2009.

PhD student, Enxhela Sulo, was first author on an interesting study that was recently published in the International Journal of Cardiology. The study analyzed trends in the use of coronary angiography and revascularization – including percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) – relating to a patient’s first AMI, and explored  any potential educational inequalities in receiving such procedures. The data covered patients aged 35-89, hospitalized for a first AMI during the period 2001-2009.

 

Socioeconomic disparities persist in treatment

The article states that early coronary revascularization is the cornerstone in AMI treatment, and that PCI is the treatment of choice for the majority of patients. However, it highlights that despite positive trends in the incidence and survival of patients with coronary heart disease, socioeconomic disparities persist, including significant educational gradients.

Among patients 55 years of age and older, those with lower levels of education were less likely to be treated with coronary revascularization compared to their counterparts with higher education. This socioeconomic inequality has been also reported from other countries, even those with universal health coverage such as Norway.

 

Both negative and positive trends

 

The article also contained good news: this disparity showed a decrease over the study period (2001-2009), indicating that there may be improved awareness of coronary heart disease symptoms and risks across all socioeconomic groups, and resulting in patients delaying less before seeking medical treatment and being better able to communicate with healthcare providers.

Read article:

Coronary angiography and myocardial revascularization following the first acute myocardial infarction in Norway during 2001-2009: Analyzing time trends and educational inequalities using data from the CVDNOR project.

Sulo E, Nygård O, Vollset SE, Igland J, Sulo G, Ebbing M, Egeland GM, Hawkins NM, Tell GS.

Int J Cardiol. 2016 Jun 1;212:122-8. doi: 10.1016/j.ijcard.2016.03.050. Epub 2016 Mar 19.

 

The CVDNOR project ‘Cardiovascular Disease in Norway’ (CVDNOR) project (PI, prof. Grethe S Tell) was established (www.cvdnor.no ) because Norway did not have a national cardiovascular disease register before 2012.  CVDNOR contains information on all hospitalizations in Norway due to cardiovascular disease or diabetes during 1994-2014. Researchers from UiB used data from CVDNOR to study trends and educational differences in receiving invasive procedures among patients hospitalized with a first acute myocardial infarction (AMI) in Norway during 2001-2009.

 

PhD student, Enxhela Sulo, was first author on an interesting study that was recently published in the International Journal of Cardiology. The study analyzed trends in the use of coronary angiography and revascularization – including percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) – relating to a patient’s first AMI, and explored  any potential educational inequalities in receiving such procedures. The data covered patients aged 35-89, hospitalized for a first AMI during the period 2001-2009.

 

Socioeconomic disparities persist in treatment

 

The article states that early coronary revascularization is the cornerstone in AMI treatment, and that PCI is the treatment of choice for the majority of patients. However, it highlights that despite positive trends in the incidence and survival of patients with coronary heart disease, socioeconomic disparities persist, including significant educational gradients.

 

Among patients 55 years of age and older, those with lower levels of education were less likely to be treated with coronary revascularization compared to their counterparts with higher education. This socioeconomic inequality has been also reported from other countries, even those with universal health coverage such as Norway.

 

Both negative and positive trends

 

The article also contained good news: this disparity showed a decrease over the study period (2001-2009), indicating that there may be improved awareness of coronary heart disease symptoms and risks across all socioeconomic groups, and resulting in patients delaying less before seeking medical treatment and being better able to communicate with healthcare providers.

 

Read article:

Coronary angiography and myocardial revascularization following the first acute myocardial infarction in Norway during 2001-2009: Analyzing time trends and educational inequalities using data from the CVDNOR project.

Sulo E, Nygård O, Vollset SE, Igland J, Sulo G, Ebbing M, Egeland GM, Hawkins NM, Tell GS.

Int J Cardiol. 2016 Jun 1;212:122-8. doi: 10.1016/j.ijcard.2016.03.050. Epub 2016 Mar 19.

 

Read more about the article in Norwegian:

Enxhela Sulo’s blog on the CVDNOR web pages: Lavt utdannede får sjeldnere utblokking ved hjerteinfarkt

Aftenposten article: Lavt utdannede får sjeldnere utblokking ved hjerteinfarkt