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ACC: Neighborhood Tied to Death Risk After Surviving a Heart Attack

THURSDAY, May 13, 2021 -- Neighborhood disadvantage is independently associated with increased mortality after myocardial infarction (MI), according to a study presented at the annual meeting of the American College of Cardiology, held virtually from May 15 to 17.

Jesse Goitia, M.D., from the Kaiser Permanente Los Angeles Medical Center, and colleagues investigated the association between neighborhood disadvantage (using the Area Deprivation Index) and long-term mortality after MI. The analysis included 31,747 patients admitted to a Southern California Kaiser Permanente hospital with acute MI (from 2006 through 2016).

The researchers found that after 5.2 years of follow-up, after adjusting for age, sex, race/ethnicity, comorbidities, and medications, living in a disadvantaged neighborhood was independently associated with increased all-cause mortality after MI (hazard ratio, 1.05). The worst mortality was seen among Black patients from disadvantaged neighborhoods versus White patients from well-resourced neighborhoods (hazard ratio, 1.19) and White patients from disadvantaged neighborhoods (hazard ratio, 1.14). Compared with White patients, Black patients from well-resourced neighborhoods did not have worse mortality.

"A key takeaway from our study is that there are a lot of social and environmental factors that can affect a person's outcome after a heart attack," Goitia said in a statement. "I think that a broad, overarching approach to start addressing those factors at the neighborhood level would pay dividends for businesses, health insurers, providers, and patients."

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