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Abstract

Background: Although socioeconomic status (SES) is a well-established predictor of health outcomes, less is known about how it affects major adverse cardiac events (MACE) following percutaneous coronary intervention (PCI), especially in poor countries. Methods: Between January and December 2024, 250 patients who received PCI at a tertiary care hospital, Quetta participated in a prospective qualitative study. Based on their occupation, income, and level of education, patients were divided into three SES groups: low, middle, and high. Semi-structured interviews, focus groups, and medical record analysis were used to gather data. Key patterns in patient experiences and healthcare access were evaluated using thematic analysis. Results: Low-SES patients had the highest incidence of MACE (52%) compared to middle- and high-SES patients (31% and 20%, respectively. 70% of the low-SES group reported irregular medication use, and 60% missed follow-up sessions, indicating significantly worse medication adherence and follow-up compliance. Low-SES patients also had higher rates of psychological stress and impediments to accessing healthcare (78% and 65%, respectively). Furthermore, compared to 72% of middle-class patients and 90% of high-class patients, only 38% of low-SES patients expressed satisfaction with their post-PCI care. Conclusion: Poorer post-PCI outcomes, such as increased incidence of MACE, decreased medication adherence, and increased psychosocial stress, are linked to lower SES. To improve long-term cardiovascular health in socioeconomically disadvantaged groups, addressing these inequities calls for a multimodal strategy that includes improved healthcare accessibility, focused education activities, and financial support programs.