Inequity in Primary and Secondary Preventive Care for Acute Myocardial Infarction? Use by Socioeconomic Status Across Middle-Aged and Older Patients

Cohen, Deborah; Dujovny, Manuel; Tugwell, Peter; Ramsay, Tim; Sanmartin, Claudia

doi:10.1016/j.cjca.2013.06.004

Cited by 11 publications

(6 citation statements)

References 28 publications

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“…However, this reduction of tolerance to ischemia was not evidenced in the infarct size of C57/BI6 mice at 13 month old, subjected to 30 min of ischemia and 2 h of reperfusion (in vitro) [89]. Taken together, and although it is clear that I/R injury is exacerbated in elderly populations, it is not clear whether this also occurs in middle-aged, when the deleterious effects of aging are already taking place [90,91]. This lack of studies in middle-aged is striking, since an ischemic episode in patients begins at that stage of life, and they are not exclusive of advanced age [90,91].…”

Section: Thioredoxin In Aging Heartsmentioning

confidence: 69%

“…Taken together, and although it is clear that I/R injury is exacerbated in elderly populations, it is not clear whether this also occurs in middle-aged, when the deleterious effects of aging are already taking place [90,91]. This lack of studies in middle-aged is striking, since an ischemic episode in patients begins at that stage of life, and they are not exclusive of advanced age [90,91]. However, it is known that even though oxidation processes start when life begins; it is in middle-aged that they reach sufficient levels to trigger deleterious mechanisms on different cell components [92], and this ROS increase is able to modify expression and/or activity of several proteins [93][94][95].…”

Section: Thioredoxin In Aging Heartsmentioning

confidence: 95%

See 1 more Smart Citation

Role of thioredoxin-1 in ischemic preconditioning, postconditioning and aged ischemic hearts

D'Annunzio

Pérez

Boveris

et al. 2016

Pharmacological Research

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Section: Thioredoxin In Aging Heartsmentioning

confidence: 69%

Section: Thioredoxin In Aging Heartsmentioning

confidence: 95%

Role of thioredoxin-1 in ischemic preconditioning, postconditioning and aged ischemic hearts

D'Annunzio

Pérez

Boveris

et al. 2016

Pharmacological Research

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“…It is also widely known that I/R injury is exacerbated in elderly populations and that many of the protective mechanisms lose their effect with advanced age [ 6 , 7 ]. But it is not clear whether this also occurs in middle-aged, when the deleterious effects of aging are already taking place [ 8 , 9 ]. This lack of studies in middle-aged is striking, since ischemic episodes in patients begins at that stage of life, and they are not exclusive of advanced age [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…But it is not clear whether this also occurs in middle-aged, when the deleterious effects of aging are already taking place [ 8 , 9 ]. This lack of studies in middle-aged is striking, since ischemic episodes in patients begins at that stage of life, and they are not exclusive of advanced age [ 8 , 9 ]. There are numerous experimental evidence showing that mice older than 18 months exhibit a significant increment in reactive oxygen and nitrogen species (ROS and RNS) thus exacerbating I/R damage [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Loss of myocardial protection against myocardial infarction in middle-aged transgenic mice overexpressing cardiac thioredoxin-1

et al. 2016

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Thioredoxin-1 (Trx1) protects the heart from ischemia/reperfusion (I/R) injury. Given that the age at which the first episode of coronary disease takes place has considerably decreased, life at middle-aged (MA) emerges as a new field of study. The aim was determine whether infarct size, Trx1 expression and activity, Akt and GSK-3β were altered in young (Y) and MA mice overexpressing cardiac Trx1, and in a dominant negative (DN-Trx1) mutant of Trx1. Langendorff-perfused hearts were subjected to 30 minutes of ischemia and 120 minutes of reperfusion (R). We used 3 and 12 month-old male of wild type (WT), Trx1, and DN-Trx1. Trx1 overexpression reduced infarct size in young mice (WT-Y: 46.8±4.1% vs. Trx1-Y: 27.6±3.5%, p < 0.05). Trx1 activity was reduced by 52.3±3.2% (p < 0.05) in Trx1-MA, accompanied by an increase in nitration by 17.5±0.9%, although Trx1 expression in transgenic mice was similar between young and middle-aged. The expression of p-Akt and p-GSK-3β increased during reperfusion in Trx1-Y. DN-Trx1 mice showed neither reduction in infarct size nor Akt and GSK-3β phosphorylation. Our data suggest that the lack of protection in Trx1 middle-aged mice even with normal Trx1 expression may be associated to decreased Trx1 activity, increased nitration and inhibition of p-Akt and p-GSK-3β.

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“…8,9 Low SES is associated with higher emergency department use 10,11 and lower access to preventive health services. [12][13][14] Importantly, there is a high burden of chronic disease among people with low SES, 15,16 and low SES is a risk factor for poor asthma-related health outcomes. 17,18 Further, there are known intersections of both chronic disease status and SES with other social determinants of health.…”

mentioning

confidence: 99%

Does socio-economic status or having a chronic condition affect whether family physicians accept a new patient? A Nova Scotia population study

Marshall

Nadeau

Lawson

et al. 2017

Can J Public Health

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OBJECTIVES:To determine whether socio-economic status (SES) and presence of a chronic condition are associated with the response a prospective patient receives when seeking a family physician (FP).METHODS: Scripted telephone calls (indicating higher or lower SES and presence or absence of a chronic condition) were made to all 327 FP offices in Nova Scotia (NS) requesting an appointment. The main outcome measures were the responses to callers seeking a FP: being accepted for an appointment or being offered further assistance if not accepted (e.g., walk-in clinic, alternative provider, and telehealth), as well as the callers' perception of the experience as positive, negative, or neutral.RESULTS: Only 9.9% of offices accepted callers as new patients. There were no statistically significant differences by SES or chronic condition in the proportion of calls resulting in an appointment. Callers indicating high SES were more likely to be provided further assistance than those with low SES (p = 0.06), and callers indicating a chronic condition reported a better overall experience than those without (p = 0.03).CONCLUSION: First contact accessibility for prospective new patients was low across NS. Lower SES was associated with fewer offers of additional assistance than higher SES. This is particularly troubling since those with lower SES may need additional support as they may have less access to resources and networks that could provide support. This study signals the need to improve general and equitable accessibility to primary care providers.KEY WORDS: Primary health care; general practice; chronic disease; social class; access to health care; health equity La traduction du résumé se trouve à la fin de l'article.

show abstract

Inequity in Primary and Secondary Preventive Care for Acute Myocardial Infarction? Use by Socioeconomic Status Across Middle-Aged and Older Patients

Cited by 11 publications

References 28 publications

Role of thioredoxin-1 in ischemic preconditioning, postconditioning and aged ischemic hearts

Role of thioredoxin-1 in ischemic preconditioning, postconditioning and aged ischemic hearts

Loss of myocardial protection against myocardial infarction in middle-aged transgenic mice overexpressing cardiac thioredoxin-1

Does socio-economic status or having a chronic condition affect whether family physicians accept a new patient? A Nova Scotia population study

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