Association of household income and adverse outcomes in patients with atrial fibrillation
Association of household income and adverse outcomes in patients with atrial fibrillation
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DOI：
10.1136/heartjnl-2019-316065
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发表时间：
2020-11-01
期刊：
影响因子：
5.7
通讯作者：
Magnani, Jared W.
中科院分区：
文献类型：
--
作者：
LaRosa, Anna Rose;Claxton, J'Neka;Magnani, Jared W.
背景健康的社会决定因素与心血管结果相关，但在房颤(房颤)中的研究有限。目的本研究的目的是检验个人家庭年收入和心血管结果与房颤的关系。方法我们分析了2009年至2015年健康声明数据库中收集的房颤患者的管理声明。我们把家庭年收入估计数归类为10万美元。协变量包括人口统计学、教育程度、心血管疾病危险因素、合并症和抗凝。结果我们分析了336 736名房颤患者(年龄72.7+/-11.9岁；44.5%的女性；82.6%的白人，8.4%的黑人，7.0%的西班牙裔和2.1%的亚洲人)房颤患者的中位数(第25和第75百分位数)为1.5年(95%可信区间0.6至3.0)。我们观察到收入与心力衰竭和心肌梗死(MI)之间的负相关关系，并有证据表明收入下降的类别中存在进行性风险。家庭收入为100 000美元的个体。结论我们在一大群房颤患者中确定了低家庭收入与不良后果之间的关联。我们的发现支持在评估房颤患者的心血管风险时考虑收入。
BackgroundSocial determinants of health are relevant to cardiovascular outcomes but have had limited examination in atrial fibrillation (AF).ObjectivesThe purpose of this study was to examine the association of annual household income and cardiovascular outcomes in individuals with AF.MethodsWe analysed administrative claims for individuals with AF from 2009 to 2015 captured by a health claims database. We categorised estimates of annual household income as =$100 000. Covariates included demographics, education, cardiovascular disease risk factors, comorbid conditions and anticoagulation. We examined event rates by income category and in multivariable-adjusted models in reference to the highest income category (>=$100 000).ResultsOur analysis included 336 736 individuals (age 72.7 +/- 11.9 years; 44.5% women; 82.6% white, 8.4% black, 7.0% Hispanic and 2.1% Asian) with AF followed for median (25th and 75th percentile) of 1.5 (95% CI 0.6 to 3.0) years. We observed an inverse association between income and heart failure and myocardial infarction (MI) with evidence of progressive risk across decreased income categories. Individuals with household income =$100 000.ConclusionsWe identified an association between lower household income and adverse outcomes in a large cohort of individuals with AF. Our findings support consideration of income in the evaluation of cardiovascular risk in individuals with AF.