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Marital status and occupation in relation to short-term case fatality after a first coronary event--a population based cohort.

Gerward S, Tydén P, Engström G, Hedblad B - BMC Public Health (2010)

Bottom Line: After risk factor adjustments, unmarried status in men, but not in women, was significantly associated with increased risk of suffering a CE [hazard ratios (HR) 1.10, 95% CI: 0.97-1.24; 1.42: 1.27-1.58 and 1.77: 1.31-2.40 for never married, divorced and widowed, respectively, compared to married].Unmarried status, in both gender, was also related with an increased CFR (1st day), taking potential confounders into account (odds ratio (OR) 2.14, 95% CI: 1.63-2.81; 1.91: 1.50-2.43 and 1.49: 0.77-2.89 for never married, divorced and widowed, respectively, compared to married men.No differences in CFR (1st day) were observed between occupational groups in neither gender.

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Affiliation: Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, Skåne University Hospital, Malmö, Sweden. sofia.gerward@med.lu.se

ABSTRACT

Background: Although marital status and low occupation level has been associated with mortality, the relationship with case fatality rates (CFR) after a coronary event (CE) is unclear. This study explored whether incidence of CE and short-term CFR differ between groups defined in terms of marital status and occupation, and if this could be explained by biological and life-style risk factors.

Methods: Population-based cohort study of 33,224 subjects (67% men), aged 27 to 61 years, without history of myocardial infarction, who were enrolled between 1974 and 1992. Incidence of CE, and CFR (death during the first day or within 28 days after CE, including out-of-hospital deaths) was examined over a mean follow-up of 21 years.

Results: A total of 3,035 men (6.0 per 1000 person-years) and 507 women (2.4 per 1000) suffered a first CE during follow-up. CFR (during the 1st day) was 29% in men and 23% in women. After risk factor adjustments, unmarried status in men, but not in women, was significantly associated with increased risk of suffering a CE [hazard ratios (HR) 1.10, 95% CI: 0.97-1.24; 1.42: 1.27-1.58 and 1.77: 1.31-2.40 for never married, divorced and widowed, respectively, compared to married]. Unmarried status, in both gender, was also related with an increased CFR (1st day), taking potential confounders into account (odds ratio (OR) 2.14, 95% CI: 1.63-2.81; 1.91: 1.50-2.43 and 1.49: 0.77-2.89 for never married, divorced and widowed, respectively, compared to married men. Corresponding figures for women was 2.32: 0.93-5.81; 1.87: 1.04-3.36 and 2.74: 1.03-7.28. No differences in CFR (1st day) were observed between occupational groups in neither gender.

Conclusions: In this population-based Swedish cohort, short-term CFR was significantly related to unmarried status in men and women. This relationship was not explained by biological-, life-style factors or occupational level.

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Hazard ratios for incident coronary event by occupational level in men (M) and women (W). Age-adjusted hazard ratios (HR), with 95% confidence interval (CI) is presented, using high-level non-manual occupation level as the reference group.
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Figure 3: Hazard ratios for incident coronary event by occupational level in men (M) and women (W). Age-adjusted hazard ratios (HR), with 95% confidence interval (CI) is presented, using high-level non-manual occupation level as the reference group.

Mentions: As shown in Figure 3, the age-adjusted HR for incident CE was significantly higher in men belonging to all other occupational levels compared to men with high-level nonmanual occupation. Further adjustments for biological- and life-style factors and marital status did not substantially change this relationship (data not shown). A similar association between occupational level and incident CE was observed among women (Figure 3), however, this was not significant after correction for biological- and life-style factors (data not shown).


Marital status and occupation in relation to short-term case fatality after a first coronary event--a population based cohort.

Gerward S, Tydén P, Engström G, Hedblad B - BMC Public Health (2010)

Hazard ratios for incident coronary event by occupational level in men (M) and women (W). Age-adjusted hazard ratios (HR), with 95% confidence interval (CI) is presented, using high-level non-manual occupation level as the reference group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2874781&req=5

Figure 3: Hazard ratios for incident coronary event by occupational level in men (M) and women (W). Age-adjusted hazard ratios (HR), with 95% confidence interval (CI) is presented, using high-level non-manual occupation level as the reference group.
Mentions: As shown in Figure 3, the age-adjusted HR for incident CE was significantly higher in men belonging to all other occupational levels compared to men with high-level nonmanual occupation. Further adjustments for biological- and life-style factors and marital status did not substantially change this relationship (data not shown). A similar association between occupational level and incident CE was observed among women (Figure 3), however, this was not significant after correction for biological- and life-style factors (data not shown).

Bottom Line: After risk factor adjustments, unmarried status in men, but not in women, was significantly associated with increased risk of suffering a CE [hazard ratios (HR) 1.10, 95% CI: 0.97-1.24; 1.42: 1.27-1.58 and 1.77: 1.31-2.40 for never married, divorced and widowed, respectively, compared to married].Unmarried status, in both gender, was also related with an increased CFR (1st day), taking potential confounders into account (odds ratio (OR) 2.14, 95% CI: 1.63-2.81; 1.91: 1.50-2.43 and 1.49: 0.77-2.89 for never married, divorced and widowed, respectively, compared to married men.No differences in CFR (1st day) were observed between occupational groups in neither gender.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, Skåne University Hospital, Malmö, Sweden. sofia.gerward@med.lu.se

ABSTRACT

Background: Although marital status and low occupation level has been associated with mortality, the relationship with case fatality rates (CFR) after a coronary event (CE) is unclear. This study explored whether incidence of CE and short-term CFR differ between groups defined in terms of marital status and occupation, and if this could be explained by biological and life-style risk factors.

Methods: Population-based cohort study of 33,224 subjects (67% men), aged 27 to 61 years, without history of myocardial infarction, who were enrolled between 1974 and 1992. Incidence of CE, and CFR (death during the first day or within 28 days after CE, including out-of-hospital deaths) was examined over a mean follow-up of 21 years.

Results: A total of 3,035 men (6.0 per 1000 person-years) and 507 women (2.4 per 1000) suffered a first CE during follow-up. CFR (during the 1st day) was 29% in men and 23% in women. After risk factor adjustments, unmarried status in men, but not in women, was significantly associated with increased risk of suffering a CE [hazard ratios (HR) 1.10, 95% CI: 0.97-1.24; 1.42: 1.27-1.58 and 1.77: 1.31-2.40 for never married, divorced and widowed, respectively, compared to married]. Unmarried status, in both gender, was also related with an increased CFR (1st day), taking potential confounders into account (odds ratio (OR) 2.14, 95% CI: 1.63-2.81; 1.91: 1.50-2.43 and 1.49: 0.77-2.89 for never married, divorced and widowed, respectively, compared to married men. Corresponding figures for women was 2.32: 0.93-5.81; 1.87: 1.04-3.36 and 2.74: 1.03-7.28. No differences in CFR (1st day) were observed between occupational groups in neither gender.

Conclusions: In this population-based Swedish cohort, short-term CFR was significantly related to unmarried status in men and women. This relationship was not explained by biological-, life-style factors or occupational level.

Show MeSH
Related in: MedlinePlus