Prognosis after heart attack depends on where you live, study finds

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Patients living in disadvantaged neighborhoods are more likely to die within five years of a heart attack compared to those living in wealthier neighborhoods, according to research set to be presented May 15-17 during the American College of Cardiology's 70th Annual Scientific Session. 

The study involved data from nearly 32,000 patients who were treated for a heart attack at Kaiser Permanente Southern California hospitals between 2006-16. Researchers used a validated index to evaluate patients based on their neighborhood disadvantage score, which accounts for 17 variables including income and education. 

About 20,000 patients scored in the top 25th percentile, indicating well-resourced neighborhoods, while about 12,000 scored in the bottom 75th percentile, representing disadvantaged neighborhoods. 

Findings showed Black patients from wealthier neighborhoods had similar outcomes to white patients from well-resourced neighborhoods. That finding was not reflected when it came to disadvantaged neighborhoods, where Black patients faced a 14 percent higher risk of death compared to white patients. 

Compared to white patients from wealthier neighborhoods, Black patients from disadvantaged areas were 19 percent more likely to die. 

Researchers did not find significant differences in the death risk between white patients from wealthier neighborhoods and from disadvantaged neighborhoods.

"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," said Jesse Goitia, MD, lead study author and cardiovascular fellow at Kaiser Permanente Los Angeles Medical Center. "Recognizing where a patient is coming from can help providers think more about their approach to follow-up care and how to best arrange that." When feasible, more frequent phone check-ins may be helpful for patients with a lack of access to transportation, Dr. Goitia explained. 

Future research will explore whether certain variables in the neighborhood quality score are more closely linked to a patient's death risk. 

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