Annual household income <$40,000 was associated with increased risk of heart failure (HR 1.17; 95% CI 1.05-1.30) compared with income ≥$100,000 in patients with atrial fibrillation.
Cohort (n=336,736)
Does lower household income increase the risk of heart failure and myocardial infarction in individuals with atrial fibrillation?
Lower household income is associated with a progressively increased risk of heart failure and myocardial infarction in patients with atrial fibrillation.
Hazard Ratio: 1.17 (95% CI 1.05–1.3)
BACKGROUND: Social determinants of health are relevant to cardiovascular outcomes but have had limited examination in atrial fibrillation (AF). OBJECTIVES: The purpose of this study was to examine the association of annual household income and cardiovascular outcomes in individuals with AF. METHODS: We 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 <40 000; 40-59 999; 60-74 999; 75-99 999; and ≥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). RESULTS: Our 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 <40 000 had the greatest risk for heart failure (HR 1. 17; 95% CI 1. 05 to 1. 30) and MI (HR 1. 18; 95% CI 0. 98 to 1. 41) compared with those with income ≥100 000. CONCLUSIONS: We 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.
LaRosa et al. (Fri,) conducted a cohort in Atrial fibrillation (n=336,736). Annual household income <$40,000 vs. Annual household income ≥$100,000 was evaluated on Heart failure (HR 1.17, 95% CI 1.05 to 1.30). Annual household income <$40,000 was associated with increased risk of heart failure (HR 1.17; 95% CI 1.05-1.30) compared with income ≥$100,000 in patients with atrial fibrillation.