The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

Venetia Notara; Demosthenes B. Panagiotakos; Yannis Kogias; Petros Stravopodis; Antonis Antonoulas; Spyros Zombolos; Yannis Mantas; Christos Pitsavos

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자료유형: 학술저널

저자정보: Venetia Notara Demosthenes B. Panagiotakos Yannis Kogias Petros Stravopodis Antonis Antonoulas Spyros Zombolos Yannis Mantas Christos Pitsavos

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제49권 제4호

발행연도: 2016.1

수록면: 220 - 229 (10page)

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Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

#Cardiovascular disease #Acute coronary syndrome #Educational staus #Social class #Risk factors #Unhealthy behaviors

참고문헌 (36)

참고문헌 신청

Marmot MG / 1987 / Social/economic status and disease / Annu Rev Public Health 8:111~135

Kaplan GA / 1993 / Socioeconomic factors and cardiovascular disease: a review of the literature / Circulation 88(4 Pt 1):1973~1998

National Bureau of Economic Research / The effects of education on health

Beauchamp A / 2010 / Inequalities in cardiovascular disease mortality: the role of behavioural, physiological and social risk factors / J Epidemiol Community Health 64(6):542~548

World Health Organization / The determinants of health

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