EFFECTS OF LOW NEIGHBOURHOOD SOCIOECONOMIC STATUS ON INFLAMMATION, OXIDATIVE STRESS, AND RISK OF MORTALITY IN PATIENTS WITH CORONARY ARTERY DISEASE

Background: Socioeconomicstatus (SES) is an influential determinant of prognosis in coronary artery disease (CAD). Patient neighbourhood SES may contribute to CAD outcomes, beyond effects of personal SES. Methods: Following 485 CAD patients for > 10 years, we examine the effect of neighbourhood income, education, and unemployment on survival, and investigate relationships between SES and markers of inflammation and oxidative stress. Results: SES was associated significantly with risk of mortality, however this relationship was not observed for cardiovascular death. Each one quintile decrease in income, education, and employment was associated with a 32%, 40% and 45% greater risk of non-cardiovascular mortality, respectively. Inflammatory and oxidative stress markers correlate with income, but do not diminish associations between neighbourhood SES and mortality. Conclusions: Significant disparities in non-cardiovascular mortality related to neighbourhood SES were observed in this study, which argues for greater attention to socioeconomic factors in chronic disease prevention and health care delivery. C.L.H. is supported bya Providence Health Research Institute & Canadian Institutes of HealthResearch MD/PhD Studentship Award, and a Michael Smith Foundation for HealthResearch Trainee Award. (colour figure available in PDF version)