Why is this study important?

The study highlights the importance of addressing socioeconomic disparities in improving cardiovascular care and outcomes. Prior studies have demonstrated an association between lower socioeconomic status (SES) with higher incidence of coronary artery disease (CAD) and greater risk of CAD-associated mortality. This study sought to address the influence of SES on long-term mortality after percutaneous coronary intervention (PCI) in a diverse urban population.

What question was this study supposed to answer? 

Previous research has established a link between lower SES and increased risk of coronary heart disease and mortality. There is complex interplay between socioeconomic factors and cardiovascular outcomes—the factors contributing to worse outcomes remains unclear. This study sought to address the influence of socioeconomic status (SES) on long-term mortality following PCI.

What did the study show? 

Utilizing data from the Pan-London PCI registry, encompassing 123,780 consecutive PCI procedures over a 10-year period, the study evaluated the association between SES and long-term mortality. Patients from the most deprived quintile demonstrated significantly younger age at time of presentation, higher rates of adverse baseline characteristics, including higher prevalence of comorbidities, and higher frequency of acute coronary syndrome presentations. 

Despite similar procedural success and complication rates across SES, patients in the most deprived quintile exhibited progressively higher long-term all-cause mortality rates compared to those in the least deprived quintile.

Multivariate analysis, adjusted for confounding variables known to affect PCI outcomes, confirmed that lower SES remained independently associated with increased long-term mortality following PCI (HR 1.13 [95% CI: 1.07-1.32]).

Key takeaway

Patients from lower socioeconomic backgrounds, defined by a validated deprivation index based on postal code, exhibit significantly higher long-term all-cause mortality rates following PCI compared to those from higher socioeconomic backgrounds. This remains true after adjustment for several variables known to affect PCI outcomes.