Key result
Low-level education was associated with a lower likelihood of receiving AVR (OR 0.85) and higher 1-year mortality after AVR (OR 1.32) compared to high-level education in patients with aortic stenosis.
Why the study?
This study aimed to determine temporal trends and socioeconomic differences in treatment and mortality following a diagnosis of aortic stenosis.
Does socioeconomic status (education level) impact the rate of AVR treatment and mortality in patients with aortic stenosis?
Cohort (n=45,026)
Does socioeconomic status (education level) impact the rate of AVR treatment and mortality in patients with aortic stenosis?
Odds Ratio: 0.85
Lower educational level is associated with decreased rates of aortic valve replacement and increased mortality in patients with aortic stenosis, highlighting significant socioeconomic disparities in care.
Persistent educational disparities in AVR access may reflect inequities; hypothesis-generating for equity-focused interventions in aortic stenosis.
AIMS: This study aims at determining the temporal trends and the socioeconomic differences in treatment and mortality following a diagnosis of aortic stenosis. METHODS AND RESULTS: A total of 45,026 patients with a first-time diagnosis of aortic stenosis were identified in the Danish National Patient Registry in the period 2000-17. The risk of AVR within the first year after diagnosis decreased (OR = 1.84 in 2000-02 compared to 2015-16) and the risk was lower in the low-level educational group (OR = 0.85) and in the medium-level group (OR = 0.94) compared to high-level education. The risk of death after AVR within the first year decreased (OR = 2.25 in 2000-02 compared to 2015-16) and the risk was higher in the low-level educational group (OR = 1.32) and in the medium-level group (OR = 1.28) compared to high-level education. The risk of death within the first year after diagnosis, for those patients who did not get an AVR during the follow-up, decreased (OR = 3.08 in 2000-02 compared to 2015-16) and the risk was higher in the low-level educational group (OR = 1.21) and in the medium-level group (OR = 1.10) compared to high-level education. CONCLUSION: Since 2000 there has been a decrease in both AVR treatment rate, mortality rate after AVR and mortality rate in patients not receiving AVR. For patients with lower-level education there is lower AVR treatment rate, higher mortality rate after AVR and higher mortality rate in patients not receiving AVR.
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Kappelgaard et al. (2021) conducted a cohort in aortic stenosis (n=45,026). Low-level education vs. High-level education was evaluated on AVR within the first year after diagnosis (OR 0.85). Low-level education was associated with a lower likelihood of receiving AVR (OR 0.85) and higher 1-year mortality after AVR (OR 1.32) compared to high-level education in patients with aortic stenosis.
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