Evidence map›Paper›PMID 25398888›Full record

ArticleJournal of the American Heart Association2014

Socioeconomic inequalities in quality of care and outcomes among patients with acute coronary syndrome in the modern era of drug eluting stents.

Celina M Yong, Freddy Abnousi, Steven M Asch, Paul A Heidenreich

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed.

  1. Trial
  2. Socioeconomic Disparities in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Cardiomyopathy.Journal of the Society for Cardiovascular Angiography & Interventions · 2025
    Article
  3. Review
  4. Article
  5. Article
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  8. Racial/Ethnic, Sex, and Economic Disparities in the Utilization and Outcomes of Intracoronary Imaging.Journal of the Society for Cardiovascular Angiography & Interventions · 2024
    Article
  9. Review
  10. Article
  11. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Celina M YongStanford University/Stanford Cardiovascular Institute, Palo Alto, CA (C.M.Y., F.A., P.A.H.) VA Palo Alto Health Care System, Palo Alto, CA (C.M.Y., S.M.A., P.A.H.).
Freddy AbnousiStanford University/Stanford Cardiovascular Institute, Palo Alto, CA (C.M.Y., F.A., P.A.H.).
Steven M AschVA Palo Alto Health Care System, Palo Alto, CA (C.M.Y., S.M.A., P.A.H.) Division of General Medical Disciplines, Stanford University School of Medicine, Palo Alto, CA (S.M.A.).
Paul A HeidenreichStanford University/Stanford Cardiovascular Institute, Palo Alto, CA (C.M.Y., F.A., P.A.H.) VA Palo Alto Health Care System, Palo Alto, CA (C.M.Y., S.M.A., P.A.H.).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rapidly changing landscape of percutaneous coronary intervention provides a unique model for examining disparities over time. Previous studies have not examined socioeconomic inequalities in the current era of drug eluting stents (DES). METHODS AND

resultsWe analyzed 835 070 hospitalizations for acute coronary syndrome (ACS) from the Healthcare Cost and Utilization Project across all insurance types from 2008 to 2011, examining whether quality of care and outcomes for patients with ACS differed by income (based on zip code of residence) with adjustment for patient characteristics and clustering by hospital. We found that lower-income patients were less likely to receive an angiogram within 24 hours of a ST elevation myocardial infarction (STEMI) (69.5% for IQ1 versus 73.7% for IQ4, P<0.0001, OR 0.79 [0.68 to 0.91]) or within 48 hours of a Non-STEMI (47.6% for IQ1 versus 51.8% for IQ4, P<0.0001, OR 0.86 [0.75 to 0.99]). Lower income was associated with less use of a DES (64.7% for IQ1 versus 71.2% for IQ4, P<0.0001, OR 0.83 [0.74 to 0.93]). However, no differences were found for coronary artery bypass surgery. Among STEMI patients, lower-income patients also had slightly increased adjusted mortality rates (10.8% for IQ1 versus 9.4% for IQ4, P<0.0001, OR 1.17 [1.11 to 1.25]). After further adjusting for time to reperfusion among STEMI patients, mortality differences across income groups decreased.

conclusionsFor the most well accepted procedural treatments for ACS, income inequalities have faded. However, such inequalities have persisted for DES use, a relatively expensive and until recently, controversial revascularization procedure. Differences in mortality are significantly associated with differences in time to primary PCI, suggesting an important target for understanding why these inequalities persist.

Indexed as

Drug-Eluting StentsHealthcare DisparitiesOutcome and Process Assessment, Health CareQuality Indicators, Health CareSocioeconomic FactorsAcute Coronary SyndromeAgedAged, 80 and overCoronary AngiographyFemaleHumansIncomeMaleMiddle AgedMyocardial InfarctionPercutaneous Coronary Interventionacute coronary syndromeoutcomesqualitysocioeconomic status

Identifiers

PMID25398888
PMCPMC4338689

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.