• Joaquim Barreto, Jose Carlos Quinaglia E Silva, Andrei C Sposito, and Luiz Sergio Carvalho.
• Universidade Estadual de Campinas (UNICAMP) - Laboratório de Aterosclerose e Biologia Vascular (Aterolab), Campinas, SP - Brasil.
• Arq. Bras. Cardiol. 2021 Jul 1; 117 (1): 5-12.

BackgroundLow schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood.ObjectiveTo investigate whether schooling stands as an independent risk factor for mortality in STEMI patients.MethodsSTEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and >10 years). Groups were compared by student's t test for continuous variables and qui-square for categorical. Incidence of all-cause mortality was compared with Kaplan-Meyer with Cox regression adjusted by age, gender, and GRACE score. Values of p < 0.05 were considered significant. SPSS21.0 was used for all analysis.ResultsThe mean schooling duration was 6.63±4.94 years. During the follow-up period (mean: 21 months; up to 6.8 years), 83 patients died (cumulative mortality of 15%). Mortality rate was higher among the lowest quartile compared to those in the highest quartile [18.5 vs 6.8%; HR 2.725 (95% CI: 1.27-5.83; p=0.01)]. In multivariate analysis, low schooling has lost statistical significance for all-cause mortality after adjustment for age and gender, with HR of 1.305 (95% CI: 0.538-3.16; p=0.556), and after adjustment by GRACE score with an HR of 1.767 (95% CI: .797-3.91; p=0.161).ConclusionLow schooling was not an independent risk factor for mortality in STEMI patients.

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