Neighborhood socioeconomic characteristics and statin medication in patients with myocardial infarction: a Swedish nationwide follow-up study

• Published in: BMC cardiovascular disorders Vol. 16; no. 1; p. 146
• Main Authors: Forsberg, Per-Ola, Li, Xinjun, Sundquist, Kristina
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.07.2016; BioMed Central
• Subjects: Aged; Cardiac and Cardiovascular Systems; Care and treatment; Clinical Medicine; Complications and side effects; Coronary heart disease; Dosage and administration; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Follow-Up Studies; Health aspects; Health Care Service and Management, Health Policy and Services and Health Economy; Health Sciences; Heart attack; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Hälsovetenskap; Incidence; Kardiologi; Klinisk medicin; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Myocardial infarction; Myocardial Infarction - economics; Myocardial Infarction - epidemiology; Myocardial Infarction - prevention & control; Neighborhood deprivation; Patient outcomes; Population Surveillance - methods; Public Health, Global Health, Social Medicine and Epidemiology; Residence Characteristics - statistics & numerical data; Retrospective Studies; Risk Factors; Secondary Prevention - methods; Social classes; Socioeconomic Factors; Socioeconomic status; Statins; Sweden - epidemiology; Type 2 diabetes; Sweden; Myocardial infarction; Socioeconomic status; Neighborhood deprivation; Statins
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-016-0319-y

Coronary heart disease (CHD) and myocardial infarction (MI) are associated with neighborhood-level socioeconomic status (SES). Statins are important drugs for secondary prevention of MI. However, no study has determined whether neighborhood-level SES is associated with statin medication in MI patients. We aimed to determine whether there is a difference in statin medication rate in MI patients across different levels of neighborhood SES. All patients in Sweden, diagnosed with incident MI from January 1st, 2000 until December 31(st) 2010, were followed (n = 116,840). Of these, 89.7 % received statin medication. Data were analyzed by multilevel logistic regression, with individual-level characteristics (age, marital status, family income, educational attainment, country of origin, urban/rural status and comorbidities/chronic conditions related to MI) as covariates. Low neighborhood-level SES was significantly associated with low statin medication rate (Odds Ratio 0.80). In the full model, which took into account individual-level socioeconomic characteristics and MI comorbidities, the odds no longer remained significant. Individual-level approaches may be most important in health care policies regarding statin medication in MI patients.