Income and outcomes of patients with incident atrial fibrillation. Issue 8 (15th June 2022)

• Record Type: Journal Article
• Authors: Biancari, Fausto; Teppo, Konsta; Jaakkola, Jussi; Halminen, Olli; Linna, Miika; Haukka, Jari; Putaala, Jukka; Mustonen, Pirjo; Kinnunen, Janne; Hartikainen, Juha; Aro, Aapo; Airaksinen, Juhani; Lehto, Mika
• Is Part Of: Journal of epidemiology and community health. Volume 76:Issue 8(2022)
• Page Start: 736
• Page End: 742
• Publication Date: 2022-06-15
• Subjects: CARDIOVASCULAR DISEASES -- COHORT STUDIES -- Health inequalities; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech-2022-219190
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background: Socioeconomic disparities can be associated with adverse outcomes in patients with cardiovascular diseases. The impact of personal income on the outcomes of patients with atrial fibrillation (AF) is unclear. Methods: Nationwide observational registry-based study on patients with incident AF in Finland during 2007–2018. Results: 203 154 patients (mean age 73.0±13.5; females 49.0%) were diagnosed with incident AF during the study period. Overall, 16 272 (8.0%) patients experienced first-ever ischaemic stroke and 63 420 (31.2%) died (mean follow-up 4.3±3.3 years). After adjusting for confounding factors, low personal income was associated with increased risk of overall mortality in all age strata and the incidence of first-ever stroke in patients aged <65 years and 65–74 years, but not in those ≥75 years. The magnitude of this effect was greatest in patients aged <65 years. After propensity score matching of patients <65 years in the lowest and highest quintiles of maximum personal annual income, at 10 years, those in the highest income quintile (≥€54 000) had significantly lower risk of first-ever stroke (subdistribution HR 0.495, 95% CI 0.391 to 0.628) and overall mortality (HR 0.307, 95% CI 0.269 to 0.351) compared with patients in the lowest income quintile (≤€12 000). Conclusions: Personal annual income has a significant impact on the incidence of first-ever ischaemic stroke and overall mortality among patients with incident AF, particularly among patients of working age. Low-income indicate the need for intervention strategies to improve outcomes of AF. Trial registration number: NCT04645537 .