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. 2012;7(9):e46314.
doi: 10.1371/journal.pone.0046314. Epub 2012 Sep 25.

Socioeconomic status correlates with the prevalence of advanced coronary artery disease in the United States

Bronislava Bashinskaya  1 , Brian V Nahed, Brian P Walcott, Jean-Valery C E Coumans, Oyere K Onuma
Affiliations

Socioeconomic status correlates with the prevalence of advanced coronary artery disease in the United States

Bronislava Bashinskaya et al. PLoS One. 2012.

Abstract

Background: Increasingly studies have identified socioeconomic factors adversely affecting healthcare outcomes for a multitude of diseases. To date, however, there has not been a study correlating socioeconomic details from nationwide databases on the prevalence of advanced coronary artery disease. We seek to identify whether socioeconomic factors contribute to advanced coronary artery disease prevalence in the United States.

Methods and findings: State specific prevalence data was queried form the United States Nationwide Inpatient Sample for 2009. Patients undergoing percutaneous coronary angioplasty and coronary artery bypass graft were identified as principal procedures. Non-cardiac related procedures, lung lobectomy and hip replacement (partial and total) were identified and used as control groups. Information regarding prevalence was then merged with data from the Behavioral Risk Factor Surveillance System, the largest, on-going telephone health survey system tracking health conditions and risk behaviors in the United States. Pearson's correlation coefficient was calculated for individual socioeconomic variables including employment status, level of education, and household income. Household income and education level were inversely correlated with the prevalence of percutaneous coronary angioplasty (-0.717; -0.787) and coronary artery bypass graft surgery (-0.541; -0.618). This phenomenon was not seen in the non-cardiac procedure control groups. In multiple linear regression analysis, socioeconomic factors were significant predictors of coronary artery bypass graft and percutaneous transluminal coronary angioplasty (p<0.001 and p=0.005, respectively).

Conclusions: Socioeconomic status is related to the prevalence of advanced coronary artery disease as measured by the prevalence of percutaneous coronary angioplasty and coronary artery bypass graft surgery.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. In-hospital morality decreases with increasing absolute frequency of a procedure.
Figure 2
Figure 2. Unemployment for greater than one year is not associated with advanced coronary artery disease.
Figure 3
Figure 3. Income is strongly correlated with the prevelance of advanced coronary artery disease.
Figure 4
Figure 4. Education level is strongly correlated with the prevalence of advanced coronary artery disease.
See this image and copyright information in PMC

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The authors have no support or funding to report.