Age, yr, mean ± SD | 65.90 ± 16.46 | 66.68 ± 14.05 | | |
< 50 (reference) | 2 494 (17.5) | 5 335 (12.5) | 1.00 | 1.00 |
50–69 | 5 212 (36.6) | 17 276 (40.6) | 1.55 (1.46–1.64) | 1.36 (1.28–1.45) |
≥70 | 6 526 (45.9) | 19 924 (46.8) | 1.43 (1.35–1.51) | 1.34 (1.26–1.43) |
Male sex | 7 545 (53.0) | 22 351 (52.5) | 0.98 (0.95–1.02) | 0.97 (0.93–1.01) |
Rural residency | 3 007 (21.1) | 6 601 (15.5) | 0.69 (0.65–0.72) | 0.91 (0.85–0.98) |
Income quintile 1 (lowest) (reference) | 3 733 (26.2) | 10 191 (24.0) | 1.00 | 1.00 |
Income quintile 2 | 3 070 (21.6) | 9 148 (21.5) | 1.09 (1.03–1.15) | 1.04 (0.98–1.11) |
Income quintile 3 | 2 720 (19.1) | 8 481 (19.9) | 1.14 (1.08–1.21) | 1.07 (1.01–1.14) |
Income quintile 4 | 2 445 (17.2) | 7 742 (18.2) | 1.16 (1.09–1.23) | 1.08 (1.01–1.15) |
Income quintile 5 (highest) | 2 264 (15.9) | 6 973 (16.4) | 1.13 (1.06–1.20) | 1.04 (0.98–1.11) |
Cardiac risk factors or previous cardiovascular conditions |
Diabetes mellitus | 5 066 (35.6) | 15 497 (36.4) | 1.04 (1.00–1.08) | 1.07 (1.02–1.12) |
Hypertension | 9 942 (69.9) | 32 680 (76.8) | 1.43 (1.37–1.49) | 1.23 (1.17–1.29) |
Dyslipidemia | 5 044 (35.4) | 18 250 (42.9) | 1.37 (1.32–1.42) | 1.14 (1.09–1.19) |
Chronic atherosclerosis | 6 556 (46.1) | 20 887 (49.1) | 1.13 (1.09–1.17) | 1.02 (0.97–1.07) |
Unstable angina | 1 880 (13.2) | 5 703 (13.4) | 1.02 (0.96–1.08) | 0.95 (0.89–1.01) |
Previous myocardial infarction | 3 979 (28.0) | 11 086 (26.1) | 0.91 (0.87–0.95) | 0.84 (0.80–0.88) |
Previous admission for heart failure | 980 (6.9) | 2 786 (6.5) | 0.95 (0.88–1.02) | 0.89 (0.82–0.97) |
Valvular heart disease | 651 (4.6) | 2 305 (5.4) | 1.20 (1.09–1.31) | 1.05 (0.96–1.16) |
Arrhythmias | 3 553 (25.0) | 11 210 (26.4) | 1.08 (1.03–1.12) | 0.92 (0.85–0.99) |
Atrial fibrillation | 2 291 (16.1) | 7 639 (18.0) | 1.14 (1.08–1.20) | 1.18 (1.08–1.28) |
Ventricular arrhythmias | 272 (1.9) | 879 (2.1) | 1.08 (0.94–1.24) | 1.13 (0.96–1.32) |
Shock | 358 (2.5) | 1 000 (2.4) | 0.93 (0.83–1.05) | 0.99 (0.87–1.13) |
Peripheral vascular disease | 893 (6.3) | 2 854 (6.7) | 1.07 (0.99–1.16) | 1.06 (0.98–1.15) |
Cerebrovascular disease | 1 830 (12.9) | 4 445 (10.5) | 0.79 (0.75–0.84) | 0.91 (0.85–0.97) |
Previous medical conditions |
Respiratory disease | 1 759 (12.4) | 5 083 (12.0) | 0.96 (0.91–1.02) | 0.99 (0.93–1.05) |
Peptic ulcer disease | 240 (1.7) | 819 (1.9) | 1.15 (0.99–1.32) | 1.09 (0.94–1.27) |
Rheumatologic disease | 170 (1.2) | 520 (1.2) | 1.02 (0.86–1.22) | 1.10 (0.92–1.33) |
Neurologic disease | 1 051 (7.4) | 1 261 (3.0) | | |
Hemiplegia or paraplegia | 359 (2.5) | 555 (1.3) | 0.51 (0.45–0.58) | 0.61 (0.52–0.71) |
Dementia | 724 (5.1) | 729 (1.7) | 0.33 (0.29–0.36) | 0.36 (0.32–0.41) |
Renal disease | 980 (6.9) | 2 419 (5.7) | 0.82 (0.76–0.88) | 0.81 (0.74–0.89) |
Cancer | 693 (4.9) | 2 881 (6.8) | 1.42 (1.30–1.55) | 1.35 (1.23–1.47) |
Anemia or blood disease | 1 230 (8.6) | 3 414 (8.0) | 0.92 (0.86–0.99) | 0.94 (0.87–1.01) |
Trauma | 1 335 (9.4) | 2 848 (6.7) | 0.69 (0.65–0.74) | 0.78 (0.72–0.84) |
Depression | 748 (5.3) | 2 038 (4.8) | 0.91 (0.83–0.99) | 1.04 (0.95–1.14) |
Charlson–Deyo comorbidity score‡ | 1.69 ± 1.65 | 1.62 ± 1.62 | | |
Events in the emergency department |
Cardiologist consultation | 260 (1.8) | 1 167 (2.7) | 1.52 (1.32–1.74) | 1.33 (1.15–1.54) |
Stress test | 56 (0.4) | 230 (0.5) | 1.38 (1.03–1.84) | 1.29 (0.95–1.76) |
Discharged against medical advice | 234 (1.6) | 599 (1.4) | 0.85 (0.73–1.00) | 0.92 (0.79–1.09) |
Use of health services in the previous year |
Primary care visit | 12 194 (85.7) | 41 667 (98.0) | 8.02 (7.39–8.70) | 6.44 (5.91–7.01) |
Cardiologist visit | 4 885 (34.3) | 19 359 (45.5) | 1.60 (1.54–1.66) | 1.36 (1.29–1.42) |
Admission to hospital | 6 706 (47.1) | 22 145 (52.1) | 1.22 (1.17–1.27) | 1.27 (1.22–1.32) |
Hospital characteristics |
Teaching hospital | 2 456 (17.3) | 7 559 (17.8) | 1.04 (0.99–1.09) | 0.88 (0.74–1.05) |
Cardiac catheterization laboratory | 3 912 (27.5) | 12 968 (30.5) | 1.16 (1.11–1.21) | 1.13 (0.96–1.32) |
Annual chest pain volume, patients/yr |
Low (< 348) (reference) | 1 189 (8.4) | 2 242 (5.3) | 1.00 | 1.00 |
Medium (348–1 237) | 3 170 (22.3) | 8 188 (19.3) | 1.37 (1.26–1.49) | 1.30 (1.14–1.50) |
High ( > 1 237) | 9 873 (69.4) | 32 105 (75.5) | 1.73 (1.60–1.86) | 1.52 (1.31–1.77) |
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