Introduction
Methods
Cohort enrolment
Exposure measures
Socioeconomic status
Co-morbidity
Outcome measures
Data analysis
Results
Baseline characteristics
Total | Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | |
---|---|---|---|---|---|---|
Number of subjects | 76,351 | 15,264 | 15,274 | 15,272 | 15,274 | 15,267 |
Male (%) | 68.4 | 76.1 | 72.6 | 69.6 | 64.0 | 59.4 |
Ethnic Dutcha (%) | 87.3 | 88.0 | 87.5 | 87.7 | 89.6 | 83.8 |
Married or living together (%) | 73.4 | 77.6 | 77.3 | 76.3 | 74.3 | 61.6 |
Degree of urbanizationb (% of quintile) | ||||||
Very urban | 16.8 | 15.2 | 15.6 | 16.9 | 17.1 | 19.1 |
Urban | 23.9 | 23.1 | 24.0 | 24.8 | 24.1 | 23.5 |
Urban/rural | 20.9 | 22.2 | 21.2 | 21.4 | 20.6 | 19.4 |
Rural | 22.6 | 24.1 | 23.6 | 21.9 | 21.9 | 21.4 |
Very rural | 15.8 | 15.5 | 15.6 | 14.9 | 16.2 | 16.6 |
Charson Index >0 (%) | 14.9 | 11.3 | 12.4 | 15.1 | 18.1 | 17.4 |
Age at AMI (mean in years) | 66.6 | 63.6 | 63.6 | 66.0 | 70.5 | 69.2 |
Standardized disposable income in year preceding AMI (mean in euros) | 18,323 | 31,616 | 20,749 | 16,429 | 13,315 | 9,508 |
Pre-hospital mortality
<55 N (%) | 55–64 N (%) | 65–74 N (%) | 75–84 N (%) | ≥85 N (%) | Total N (%) | ASR | |
---|---|---|---|---|---|---|---|
Total | |||||||
Total | 16,695 (9.3) | 16,528 (12.8) | 18,409 (19.2) | 17,393 (28,7) | 7,326 (50.0) | 76,351 (20.8) | 20.7 |
Quintile 1a
| 4,147 (9.3) | 4,426 (12.1) | 3,138 (18.0) | 2,483 (28.1) | 1,070 (49.2) | 15,264 (17.7) | 20.1 |
Quintile 2 | 4,287 (9.0) | 3,888 (10.6) | 3,548 (18.0) | 2,616 (26.9) | 935 (46.8) | 15,274 (16.9) | 19.2 |
Quintile 3 | 3,417 (8.4) | 3,201 (12.6) | 4,114 (17.7) | 3,450 (26.8) | 1,090 (46.9) | 15,272 (18.7) | 19.4 |
Quintile 4 | 2,005 (9.1) | 2,153 (14.1) | 4,495 (20.2) | 4,902 (27.7) | 1,719 (45.4) | 15,274 (23.1) | 20.6 |
Quintile 5 | 2,839 (11.1) | 2,860 (16.2) | 3,114 (22.4) | 3,942 (33.0) | 2,512 (55.9) | 15,267 (27.4) | 24.2 |
Men | |||||||
Total | 13,191 (9.3) | 13,166 (12.8) | 12,837 (19.4) | 10,067 (28.1) | 2,957 (45.9) | 52,218 (18.4) | 18.4 |
Quintile 1a
| 3,363 (9.4) | 3,777 (12.3) | 2,394 (18.3) | 1,571 (26.7) | 505 (45.7) | 11,610 (16.1) | 17.7 |
Quintile 2 | 3,385 (9.5) | 3,167 (11.1) | 2,566 (18.0) | 1,578 (26.4) | 394 (42.6) | 11.090 (15.5) | 17.2 |
Quintile 3 | 2,710 (8.4) | 2,494 (12.7) | 2,910 (17.9) | 2,094 (26.1) | 473 (41.2) | 10,681 (16.9) | 17.1 |
Quintile 4 | 1,542 (8.5) | 1,598 (14.0) | 3,025 (21.0) | 2,865 (28.5) | 746 (43.4) | 9,776 (21.8) | 18.8 |
Quintile 5 | 2,191 (10.6) | 2,130 (15.2) | 1,942 (22.4) | 1.959 (32.2) | 839 (52.4) | 9,061 (22.7) | 21.2 |
Women | |||||||
Total | 3,504 (9.2) | 3,362 (12.9) | 5,572 (18.8) | 7,326 (29.5) | 4,369 (52.7) | 24,133 (26.0) | 26.0 |
Quintile 1a
| 784 (8.5) | 649 (10.6) | 744 (16.9) | 912 (30.6) | 565 (52.2) | 3,654 (22.9) | 25.4 |
Quintile 2 | 902 (7.1) | 721 (8.3) | 982 (18.0) | 1,038 (27.7) | 541 (49.9) | 4,184 (20.5) | 23.8 |
Quintile 3 | 707 (8.2) | 707 (12.2) | 1,204 (17.4) | 1,356 (27.8) | 617 (51.2) | 4,591 (22.8) | 24.6 |
Quintile 4 | 463 (11.2) | 555 (14.6) | 1,470 (18.5) | 2,037 (26.7) | 973 (46.9) | 5,498 (25.5) | 24.5 |
Quintile 5 | 648 (12.7) | 730 (18.9) | 1,172 (22.4) | 1,983 (33.8) | 1,673 (57.7) | 6,206 (34.1) | 30.4 |
Total OR (95 % CI) | <55 OR (95 % CI) | 55–64 OR (95 % CI) | 65–74 OR (95 % CI) | 75–84 OR (95 % CI) | ≥85 OR (95 % CI) | |
---|---|---|---|---|---|---|
Total | ||||||
Quintile 1b (reference) | 1 | 1 | 1 | 1 | 1 | 1 |
Quintile 2 | 0.94 (0.88–1.00) | 0.97 (0.84–1.13) | 0.85 (0.74–0.98) | 1.01 (0.89–1.14) | 0.94 (0.83–1.07) | 0.92 (0.77–1.10) |
Quintile 3 | 0.94 (0.89–1.00) | 0.92 (0.78–1.08) | 1.01 (0.88–1.16) | 0.97 (0.86–1.09) | 0.95 (0.84–1.06) | 0.92 (0.78–1.10) |
Quintile 4 | 1.01 (0.95–1.07) | 0.99 (0.82–1.19) | 1.15 (0.98–1.34) | 1.14 (1.02–1.29)* | 0.98 (0.88–1.09) | 0.88 (0.75–1.02) |
Quintile 5 | 1.25 (1.18–1.33)* | 1.20 (1.03–1.41)* | 1.29 (1.12–1.48)* | 1.23 (1.08–1.39)* | 1.20 (1.08–1.34)* | 1.22 (1.05–1.41)* |
P trend | <0.001 | 0.023 | <0.001 | <0.001 | <0.001 | <0.001 |
Men | ||||||
Quintile 1b (reference) | 1 | 1 | 1 | 1 | 1 | 1 |
Quintile 2 | 0.96 (0.89–1.03) | 1.01 (0.86–1.19) | 0.88 (0.76–1.02) | 0.99 (0.85–1.14) | 0.99 (0.85–1.17) | 0.88 (0.67–1.16) |
Quintile 3 | 0.95 (0.88–1.02) | 0.92 (0.77–1.10) | 0.99 (0.85–1.15) | 0.96 (0.83–1.10) | 0.99 (0.85–1.14) | 0.86 (0.66–1.11) |
Quintile 4 | 1.08 (1.00–1.16) | 0.91 (0.73–1.13) | 1.09 (0.91–1.29) | 1.17 (1.02–1.35)* | 1.10 (0.96–1.27) | 0.95 (0.76–1.20) |
Quintile 5 | 1.24 (1.15–1.33)* | 1.14 (0.95–1.37) | 1.18 (1.01–1.37)* | 1.21 (1.04–1.41)* | 1.26 (1.09–1.47)* | 1.26 (1.00–1.58) |
P trend | <0.001 | 0.191 | 0.009 | 0.001 | 0.001 | 0.005 |
Women | ||||||
Quintile 1b (reference) | 1 | 1 | 1 | 1 | 1 | 1 |
Quintile 2 | 0.90 (0.80–1.00) | 0.82 (0.57–1.17) | 0.75 (0.52–1.08) | 1.06 (0.83–1.37) | 0.87 (0.71–1.05) | 0.94 (0.74–1.19) |
Quintile 3 | 0.93 (0.84–1.04) | 0.94 (0.65–1.35) | 1.15 (0.82–1.62) | 1.00 (0.78–1.28) | 0.88 (0.73–1.06) | 0.97 (0.77–1.22) |
Quintile 4 | 0.90 (0.81–1.00) | 1.31 (0.89–1.93) | 1.40 (0.99–1.98) | 1.09 (0.86–1.37) | 0.82 (0.69–0.97)* | 0.82 (0.66–1.01) |
Quintile 5 | 1.26 (1.14–1.39)* | 1.48 (1.04–2.09)* | 1.81 (1.31–2.49)* | 1.29 (1.02–1.64)* | 1.10 (0.93–1.31) | 1.20 (0.99–1.46) |
P trend | <0.001 | 0.007 | 0.000 | 0.109 | <0.001 | <0.001 |
Case-fatality
<55 N (%) | 55–64 N (%) | 65–74 N (%) | 75–84 N (%) | ≥85 N (%) | Total N (%) | ASR | |
---|---|---|---|---|---|---|---|
Total | |||||||
Total | 15,144 (5.2) | 14,412 (8.3) | 14,871 (16.4) | 12,405 (28.9) | 3,666 (44.8) | 60,498 (16.0) | 16.0 |
Quintile 1a
| 3,597 (4.9) | 3,781 (7.3) | 2,462 (15.0) | 1,730 (27.1) | 526 (43.7) | 12,096 (12.6) | 14.9 |
Quintile 2 | 3,740 (5.3) | 3,322 (8.1) | 2,761 (16.0) | 1,809 (28.7) | 469 (45.8) | 12,101 (13.6) | 15.9 |
Quintile 3 | 3,187 (5.6) | 2,789 (8.8) | 3,265 (15.7) | 2,318 (26.7) | 542 (44.6) | 12,101 (14.9) | 15.6 |
Quintile 4 | 1.959 (4.6) | 2,000 (9.1) | 3,669 (16.2) | 3,560 (28.9) | 914 (42.7) | 12,102 (18.9) | 15.8 |
Quintile 5 | 2,661 (5.1) | 2,520 (9.0) | 2,714 (19.2) | 2,988 (31.9) | 1,215 (46.6) | 12,098 (19.9) | 17.5 |
Men | |||||||
Total | 11,693 (4.7) | 11,484 (7.9) | 10,345 (16.4) | 7,237 (29.4) | 1,599 (46.6) | 42,628 (14.2) | 14.2 |
Quintile 1a
| 2,391 (4.6) | 3,223 (6.9) | 1,875 (14.2) | 1,115 (27.9) | 265 (43.8) | 9,409 (11.2) | 13.0 |
Quintile 2 | 2,921 (4.8) | 2,692 (7.5) | 2,005 (15.8) | 1,095 (29.3) | 210 (50.0) | 8,923 (12.2) | 14.1 |
Quintile 3 | 2,530 (5.0) | 2,191 (8.4) | 2,323 (15.8) | 1,427 (26.3) | 264 (44.3) | 8,735 (13.4) | 13.7 |
Quintile 4 | 1,526 (4.1) | 1,485 (8.9) | 2,432 (16.9) | 2,077 (29.5) | 415 (44.1) | 7,935 (17.7) | 14.3 |
Quintile 5 | 2,055 (4.5) | 1,893 (8.8) | 1,710 (19.7) | 1,523 (33.2) | 445 (50.3) | 7,626 (17.4) | 16.0 |
Women | |||||||
Total | 3,181 (7.0) | 2,928 (10.0) | 4,526 (16.4) | 5,168 (28.3) | 2,067 (43.4) | 17,870 (20.3) | 20.2 |
Quintile 1a
| 666 (6.2) | 558 (9.5) | 587 (17.5) | 615 (25.7) | 261 (43.7) | 2,687 (17.5) | 19.6 |
Quintile 2 | 819 (7.1) | 630 (10.3) | 756 (16.8) | 714 (27.9) | 259 (42.5) | 3,178 (17.6) | 20.2 |
Quintile 3 | 657 (7.8) | 598 (10.4) | 942 (15.5) | 891 (27.3) | 278 (45.0) | 3,366 (18.6) | 20.1 |
Quintile 4 | 433 (6.5) | 515 (9.7) | 1,237 (15.0) | 1,483 (28.1) | 499 (41.5) | 4,167 (21.3) | 19.5 |
Quintile 5 | 606 (7.4) | 627 (9.9) | 1,004 (18.2) | 1,465 (30.5) | 770 (44.4) | 4,472 (24.1) | 21.5 |
Total OR (95 % CI) | <55 OR (95 % CI) | 55–64 OR (95 % CI) | 65–74 OR (95 % CI) | 75–84 OR (95 % CI) | ≥85 OR (95 % CI) | |
---|---|---|---|---|---|---|
Total | ||||||
Quintile 1b (reference) | 1 | 1 | 1 | 1 | 1 | 1 |
Quintile 2 | 1.09 (1.01–1.18)* | 1.09 (0.88–1.34) | 1.08 (0.91–1.29) | 1.08 (0.93–1.25) | 1.09 (0.94–1.26) | 1.10 (0.86–1.42) |
Quintile 3 | 1.06 (0.98–1.14) | 1.17 (0.95–1.46) | 1.15 (0.96–1.38) | 1.03 (0.89–1.19) | 0.99 (0.86–1.14) | 1.05 (0.83–1.35) |
Quintile 4 | 1.09 (1.01–1.17)* | 0.98 (0.75–1.27) | 1.16 (0.95–1.42) | 1.06 (0.92–1.23) | 1.10 (0.96–1.25) | 0.99 (0.79–1.23) |
Quintile 5 | 1.22 (1.13–1.32)* | 1.07 (0.85–1.35) | 1.13 (0.94–1.37) | 1.27 (1.09–1.47)* | 1.24 (1.08–1.41)* | 1.15 (0.93–1.41) |
P trend | <0.001 | 0.565 | 0.489 | 0.009 | 0.002 | 0.481 |
Men | ||||||
Quintile 1b (reference) | 1 | 1 | 1 | 1 | 1 | 1 |
Quintile 2 | 1.10 (1.00–1.21) | 1.06 (0.83–1.35) | 1.07 (0.88–1.31) | 1.13 (0.94–1.34) | 1.08 (0.89–1.30) | 1.30 (0.90–1.88) |
Quintile 3 | 1.06 (0.97–1.17) | 1.13 (0.88–1.46) | 1.18 (0.96–1.44) | 1.10 (0.93–1.31) | 0.93 (0.78–1.11) | 1.06 (0.75–1.51) |
Quintile 4 | 1.13 (1.03–1.24)* | 0.94 (0.69–1.29) | 1.23 (0.89–1.55) | 1.19 (1.00–1.41) | 1.09 (0.93–1.28) | 1.07 (0.78–1.47) |
Quintile 5 | 1.28 (1.17–1.41)* | 0.98 (0.75–1.30) | 1.19 (0.97–1.48) | 1.40 (1.17–1.68)* | 1.26 (1.06–1.50)* | 1.36 (0.99–1.85) |
P trend | <0.001 | 0.742 | 0.293 | 0.003 | 0.003 | 0.216 |
Women | ||||||
Quintile 1b (reference) | 1 | 1 | 1 | 1 | 1 | 1 |
Quintile 2 | 1.05 (0.91–1.21) | 1.20 (0.79–1.82) | 1.09 (0.74–1.59) | 0.94 (0.70–1.25) | 1.12 (0.87–1.42) | 0.95 (0.67–1.35) |
Quintile 3 | 1.02 (0.89–1.17) | 1.31 (0.86–2.02) | 1.05 (0.71–1.55) | 0.84 (0.64–1.11) | 1.09 (0.86–1.38) | 1.05 (0.74–1.48) |
Quintile 4 | 0.98 (0.86–1.11) | 1.11 (0.67–1.83) | 0.97 (0.64–1.46) | 0.80 (0.61–1.04) | 1.12 (0.90–1.39) | 0.92 (0.68–1.25) |
Quintile 5 | 1.11 (0.98–1.26) | 1.35 (0.87–2.12) | 0.96 (0.65–1.42) | 0.98 (0.75–1.29) | 1.23 (0.99–1.52) | 1.02 (0.76–1.35) |
P trend | 0.172 | 0.668 | 0.963 | 0.290 | 0.400 | 0.901 |