Socioeconomic Status as a Predictor of Mortality in Patients Admitted With Atrial Fibrillation

Kargoli, Faraj; Shulman, Eric; Aagaard, Per; Briceño, David; Hoch, Ethan; Biase, Luigi Di; Fisher, John D.; Gross, Jay N.; Kim, Soo G.; Krumerman, Andrew; Ferrick, Kevin J.

doi:10.1016/j.amjcard.2017.01.041

Cited by 32 publications

(25 citation statements)

References 28 publications

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“…29 Prior research has reported higher rates of cardiovascular disease, including AF, among those with lower SES. [30][31][32][33][34] As expected, we found that age-standardized incidence rates of AF decreased in a doseresponse fashion with higher income and education, regardless of race and sex. Our findings are consistent with a previous ARIC report that specifically focused on examining the association between SES and AF incidence.…”

Section: Discussionsupporting

confidence: 54%

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Mou

Norby

Chen

et al. 2018

Circ: Arrhythmia and Electrophysiology

163

102

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BACKGROUND:Limited information exists on the lifetime risk of atrial fibrillation (AF) in African Americans and by socioeconomic status. METHODS:We studied 15 343 participants without AF at baseline from the ARIC (Atherosclerosis Risk in Communities) cohort recruited in 1987 to 1989 from 4 communities in the United States when they were 45 to 64 years of age. Participants have been followed through 2014. Incidence rates of AF were calculated dividing the number of new cases by personyears of follow-up. Lifetime risk of AF was estimated by a modified Kaplan-Meier method considering death as a competing risk. Participants' family income and education were obtained at baseline. RESULTS:We identified 2760 AF cases during a mean follow-up of 21 years. Lifetime risk of AF was 36% (95% confidence interval, 32%-38%) in white men, 30% (95% confidence interval, 26%-32%) in white women, 21% (95% confidence interval, 13%-24%) in African American men, and 22% (95% confidence interval, 16%-25%) in African American women. Regardless of race and sex, incidence rates of AF decreased from the lowest to the highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared with their low socioeconomic status counterparts through earlier life but was reversed after age 80.

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Section: Discussionsupporting

confidence: 54%

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status

Mou

Norby

Chen

et al. 2018

Circ: Arrhythmia and Electrophysiology

163

102

View full text Add to dashboard Cite

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“…Hence, there may be a detection bias of AF in individuals with low SEP, which could make the association between low SEP and AF weaker than it actually is. Additionally, some deaths may be attributed to undiagnosed AF, possibly more often in patients with low SEP 37. On the other hand, people with low SEP are more frequently hospitalised for any cause than people with high SEP38 which could make the association stronger than it actually is.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic position and risk of atrial fibrillation: a nationwide Danish cohort study

Lunde

Joensen

Lundbye‐Christensen

et al. 2019

J Epidemiol Community Health

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AimTo examine the association between socioeconomic position and the risk of atrial fibrillation (AF) in different stages of life in a population of Danish citizens.MethodsRegister-based study. We followed all individuals turning 35, 50, 65 or 80 years from 1 January 1996 to 31 December 2005 until AF, death, emigration or the end of study period (31 December 2015). Exposure was education and income. We used Cox regression for the HRs (95% CI) and the pseudo-observation method for the adjusted risk difference (RD) (%).ResultsA total of 2 173 857 participants were enrolled and 151 340 incident cases of AF occurred over a median of 13.6 years of follow-up. Adjusted HR (95% CI) of incident AF for the youngest age group with the highest education (ref lowest) was 0.62 (0.50 to 0.77) (women) and 0.85 (0.76 to 0.96) (men). The associations attenuated with increasing age, that is, HRs for the oldest age group were 1.04 (0.97 to 1.10) and 0.98 (0.96 to 1.04), respectively. The corresponding adjusted RDs (%) were: −0.28 (−0.43 to −0.14), −0.18 (−0.36 to −0.01), 3.04 (−0.55 to 6.64) and −0.74 (−3.38 to 2.49), respectively. Similar but weaker associations were found for income.ConclusionHigher level of education and income was associated with a lower risk of being diagnosed with AF in young individuals but the association decreased with increasing age and was almost absent for the oldest age cohort. However, since AF is relatively rare in the youngest the RDs were low.

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“…Specifically, data indicate an association between social deprivation and poorer health outcomes [4] . Additional data indicate that individuals with AF who have higher social deprivation have poorer health outcomes compared to those with lower social deprivation [5] .…”

Section: Introductionmentioning

confidence: 96%