دورية أكاديمية
Social determinants of health and recurrence of atrial fibrillation after catheter ablation: a Danish nationwide cohort study.
| العنوان: | Social determinants of health and recurrence of atrial fibrillation after catheter ablation: a Danish nationwide cohort study. |
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| المؤلفون: | Vinter N; Diagnostic Centre, University Clinic for Development of Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg 8600, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark.; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg 9000, Denmark., Calvert P; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L69 3BX, UK., Kronborg MB; Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark.; Department of Cardiology, Aarhus University Hospital, Aarhus 8200, Denmark., Cosedis-Nielsen J; Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark.; Department of Cardiology, Aarhus University Hospital, Aarhus 8200, Denmark., Gupta D; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L69 3BX, UK., Ding WY; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool L69 3BX, UK., Trinquart L; Tufts Clinical and Translational Science Institute, Tufts University, Boston 02153, MA, USA.; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston 02153, MA, USA., Johnsen SP; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg 9000, Denmark., Frost L; Diagnostic Centre, University Clinic for Development of Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg 8600, Denmark.; Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark., Lip GYH; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, Liverpool Heart & Chest Hospital, Liverpool L69 3BX, UK. |
| المصدر: | European heart journal. Quality of care & clinical outcomes [Eur Heart J Qual Care Clin Outcomes] 2023 Sep 12; Vol. 9 (6), pp. 632-638. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 101677796 Publication Model: Print Cited Medium: Internet ISSN: 2058-1742 (Electronic) Linking ISSN: 20581742 NLM ISO Abbreviation: Eur Heart J Qual Care Clin Outcomes Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford : Oxford University Press, [2015]- |
| مواضيع طبية MeSH: | Atrial Fibrillation*/epidemiology , Atrial Fibrillation*/surgery , Atrial Fibrillation*/diagnosis , Catheter Ablation*, Male ; Humans ; Middle Aged ; Female ; Cohort Studies ; Social Determinants of Health ; Denmark/epidemiology |
| مستخلص: | 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. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.) |
| فهرسة مساهمة: | Keywords: Ablation; Atrial fibrillation; Education; Income; Living alone |
| تواريخ الأحداث: | Date Created: 20221027 Date Completed: 20230913 Latest Revision: 20230919 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1093/ehjqcco/qcac071 |
| PMID: | 36302141 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2058-1742 |
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| DOI: | 10.1093/ehjqcco/qcac071 |