Employment status affects mortality, recurrence in patients with first-time MI
Working-age adults with a first-time MI who were not in the workforce had higher rates of all-cause mortality and recurrent MI than individuals who were in the workforce, researchers reported.
“During the past decades, the epidemiology of cardiovascular disease has changed, with a trend toward an increase in the incidence of cardiovascular disease among young individuals,” Jeppe Kofoed Petersen, MB, of the department of cardiology, Rigshospitalet, Copenhagen University Hospital in Denmark, told Healio. “With the present research we found that individuals not being part of the workforce were at significantly higher risk of both all-cause mortality and recurrent MI. We hope these data emphasize the need for increased awareness on this patient subgroup, perhaps needing intensified rehabilitation and clinical follow-up.”
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To investigate the association between workforce status and risk for all-cause mortality and MI, Petersen and colleagues examined 16,060 adults aged 18 to 60 years in the Danish national registries with a first-time MI and without a history of ischemic heart disease between 2010 and 2018.
Participants were split into two groups based on whether they were in the workforce or not (12,540 workforce vs. 3,520 non-workforce; workforce median age, 51 years; non-workforce median age, 52 years; workforce, 77.8% men; non-workforce, 63.3% men).
The median follow-up period for all-cause mortality was 4.3 years for the workforce population and 4 years for the non-workforce population. Meanwhile, the median follow-up period for recurrent MI was 4 years for the workforce group and 3.6 years for the non-workforce group.
HRs were adjusted for age, sex, education, status on living alone, comorbidities and invasive procedure status.
During the follow-up period, researchers found that the rate of all-cause mortality was higher in individuals who were not in the workforce compared with individuals who were a part of the workforce (adjusted HR = 2.39; 95% CI, 2.01-2.83). In addition, those who were not in the workforce had higher rates of recurrent MI than those who were in the workforce (aHR = 1.36; 95% CI, 1.18-1.57).
“The relationship between employment status and adverse outcomes is complex, and as discussed in the discussions section of our paper, it is also possible that the reasons not to be part of the workforce may be associated with a higher risk of adverse outcomes,” Petersen told Healio. “These reasons would be very interesting to further characterize as some potentially reversible factors could be identified, enabling improved primary prophylaxis.”
For more information:
Jeppe Kofoed Petersen, MB, can be reached at jeppekp3008@gmail.com.
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