Socioeconomic differences in incidence and relative survival after a first acute myocardial infarction in the Basque Country, Spain

objective: to estimate the incidence and 28-day and 5-year survival rates after a first acute myocardial infarction (ami) in relation to socioeconomic status in the basque country (spain) between 1999 and 2000. methods: data from a population-based registry of ami were used. the study included 3,619 patients to calculate age-standardized incidence by the direct method and 2,003 patients (out-of-hospital deaths were excluded) to calculate observed and relative survival using the kaplan-meier and hakulinen methods, respectively. socioeconomic status was quantified using a deprivation index ecologically assigned to each patient according to the census tract of residence at diagnosis of ami and was categorized into quintiles. results: among men, the risk of ami was higher in the lowest socioeconomic group than in the highest socioeconomic group (rr=1.17; 95%ci: 1.02-1.34). in men, a higher risk of death was observed in the middle (q3; hr=1.60; 95%ci: 1.02-2.51) and low (q5; hr=1.65; 95%ci: 1.02-2.69) quintiles compared with the least deprived group for age-adjusted survival during the acute phase. in the fully adjusted model, this effect was attenuated and no significant differences were observed in long-term survival. among women, no significant differences were observed either in incidence or in short- and long-term survival. conclusions: socioeconomic inequalities were only observed in men in incidence and in survival during the acute phase after an ami.