{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:38:12Z","timestamp":1791495492620,"version":"4.3.4"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Lower socioeconomic status (SES) has been associated with increased mortality from coronary heart disease. This excess risk, relative to affluent patients, may be due to a combination of more adverse cardiovascular-risk factors, inequalities in access to cardiac investigations, longer waiting times for cardiac revascularisation and lower use of secondary prevention drugs. We sought to investigate whether socio-economic status influenced long-term all-cause mortality after PCI in a large metropolitan city (London), which serves a population of 11 million people with a mixed social background over a 10-year period. Methods: We conducted an observational cohort study of 123,780 consecutive PCI procedures from the Pan-London (United Kingdom) PCI registry. This data set is collected prospectively and includes all patients treated between January 2005 and December 2015. The database includes PCI performed for stable angina and ACS (ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina). Patient socio-economic status was defined by the English Index of Multiple Deprivation (IMD) score, according to residential postcode. Patients were analysed by quintile of IMD score (Q1, least deprived; Q5, most deprived). Median follow-up was 3.7 (IQR: 2.0\u20135.1) years and the primary outcome was all-cause mortality. Results: The mean age of the patients was 64.3 \u00b1 12.1 years and 25.2% were female. A total of 22.4% of patients were diabetic and 27.3% had a history of previous myocardial infarction. The rates of long-term all-cause mortality increased progressively across quintiles of IMD score, with patients in Q5 showing significantly higher long-term mortality rates compared with patients in Q1 (p = 0.0044). This persisted following the inclusion of a propensity score in the proportional hazard model as a covariate (HR for Q5 compared to Q1: 1.15 [95% CI: 1.10\u20131.42]). Conclusions: This study has demonstrated that low SES is an independent predictor of adverse clinical outcomes following PCI in the large, diverse metropolitan city of London. There clearly are inequalities in cardio-vascular risk factors, time to access to medical treatment\/PCI, access to complex imaging and devices during PCI, access to secondary prevention after PCI, and even race differences. Hence, attention to reducing the burden of cardiovascular risk factors and improving primary prevention, particularly in patients with lower SES, is required.<\/jats:p>","DOI":"10.3390\/jcdd12030096","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:02:59Z","timestamp":1741608179000},"page":"96","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Association of Socioeconomic Status (SES) with Procedural Management and Mortality After Percutaneous Coronary Intervention (PCI): An Observational Study from the Pan-London PCI (BCIS) Registry"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4268-5055","authenticated-orcid":false,"given":"Krishnaraj S.","family":"Rathod","sequence":"first","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pitt","family":"Lim","sequence":"additional","affiliation":[{"name":"St George\u2019s Hospital, St George\u2019s University Hospitals NHS Foundation Trust, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Firoozi","sequence":"additional","affiliation":[{"name":"St George\u2019s Hospital, St George\u2019s University Hospitals NHS Foundation Trust, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8300-3367","authenticated-orcid":false,"given":"Richard","family":"Bogle","sequence":"additional","affiliation":[{"name":"St George\u2019s Hospital, St George\u2019s University Hospitals NHS Foundation Trust, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"MacCarthy","sequence":"additional","affiliation":[{"name":"King\u2019s College Hospital, King\u2019s College Hospital NHS Foundation Trust, London SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-5093","authenticated-orcid":false,"given":"Miles C.","family":"Dalby","sequence":"additional","affiliation":[{"name":"Harefield Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, Uxbridge UB9 6JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iqbal S.","family":"Malik","sequence":"additional","affiliation":[{"name":"Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Mathur","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8719-4538","authenticated-orcid":false,"given":"James","family":"Spratt","sequence":"additional","affiliation":[{"name":"St George\u2019s Hospital, St George\u2019s University Hospitals NHS Foundation Trust, London SW17 0QT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1107-2117","authenticated-orcid":false,"given":"Ranil","family":"De Silva","sequence":"additional","affiliation":[{"name":"Harefield Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, Uxbridge UB9 6JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roby","family":"Rakhit","sequence":"additional","affiliation":[{"name":"Royal Free Hospital, Royal Free London NHS Foundation Trust, London NW3 2QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Hill","sequence":"additional","affiliation":[{"name":"Harefield Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, Uxbridge UB9 6JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundeep Singh","family":"Kalra","sequence":"additional","affiliation":[{"name":"Royal Free Hospital, Royal Free London NHS Foundation Trust, London NW3 2QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Redwood","sequence":"additional","affiliation":[{"name":"St Thomas\u2019 Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 9RT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9847-070X","authenticated-orcid":false,"given":"Richard Andrew","family":"Archbold","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wragg","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-0417","authenticated-orcid":false,"given":"Daniel A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London EC1A 7BE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1136\/jech.56.6.434","article-title":"Health inequalities in Britain: Continuing increases up to the end of the 20th century","volume":"56","author":"Dorling","year":"2002","journal-title":"J. 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