医学
危险系数
心房颤动
丹麦语
人口学
比例危险模型
队列
导管消融
人口
内科学
队列研究
烧蚀
心脏病学
置信区间
社会学
哲学
环境卫生
语言学
作者
Nicklas Vinter,Peter Calvert,Mads Brix Kronborg,Jens Cosedis-Nielsen,Dhiraj Gupta,Wern Yew Ding,Ludovic Trinquart,Søren Paaske Johnsen,Lars Frost,Gregory Y.H. Lip
出处
期刊:European Heart Journal - Quality of Care and Clinical Outcomes
[Oxford University Press]
日期:2022-10-27
卷期号:9 (6): 632-638
被引量:1
标识
DOI:10.1093/ehjqcco/qcac071
摘要
Abstract Aims To examine the associations between three social determinants of health (SDOH) and recurrence of AF after ablation. Methods and results We selected patients who underwent a first ablation after an incident hospital diagnosis of AF between 2005 and 2018 from the entire Danish population. Educational attainment, family income, and whether the patient was living alone were assessed at the time of ablation. We used cause-specific proportional hazard models to estimate hazard ratios (HR) with 95% confidence interval (CI) adjusted for age and sex. In secondary analyses, we adjusted for comorbidities, antiarrhythmic medication, and prior electrical cardioversion. We selected 9728 patients (mean age 61 years, 70% men), and 5881 patients had AF recurrence over an average of 1.37 years after ablation (recurrence rate 325.7 (95% CI 317.6–334.2) per 1000 person-years). Lower education (HR 1.09 [1.02–1.17] and 1.07 [1.01–1.14] for lower and medium vs. higher), lower income [HR 1.14 (1.06–1.22) and 1.09 (1.03–1.17) for lower and medium vs. higher], and living alone [HR 1.07 (1.00–1.13)] were associated with increased rates of recurrence of AF. We found no evidence of interaction between sex or prior HF with SDOH. The association between family income and AF recurrence was stronger among patients < 65 years compared with those aged ≥ 65 years. The associations between SDOH and AF recurrence did not persist in the multivariable model. Conclusion AF was more likely to recur among patients with lower educational attainment, lower family income, or those living alone. Multidisciplinary efforts are needed to reduce socioeconomic inequity in the effect of ablation.
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