期刊
INTERNATIONAL JOURNAL OF CARDIOLOGY
卷 202, 期 -, 页码 776-781出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2015.09.027
关键词
Neighbourhood; Atrial fibrillation; Mortality; Gender; Follow-up; Co-morbidity; Antithrombotic drugs
资金
- Swedish Research Council [K2009-70X-15428-05-3]
- ALF [K2012-70X-15428-08-3]
- National Heart, Lung, And Blood Institute of the National Institutes of Health [R01HL116381]
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL116381] Funding Source: NIH RePORTER
Objective: Our aim was to study the potential impact of neighbourhood socio-economic status (SES) on all-cause mortality in patients with atrial fibrillation (AF) treated in primary care. Methods: Study population included adults (n = 12,283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. Association between neighbourhood SES and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs), and by Laplace regression where years to death (95% CI) of the first 10% of the participants were used as an outcome. All models were conducted in both men and women and adjusted for age, educational level, marital status, change of neighbourhood status, cardiovascular co-morbidities, anticoagulant treatment and statin treatment. High-and low neighbourhood SES were compared with middle SES as reference group. Results: After adjustments for potential confounders, higher relative risk of all-cause mortality (HR 1.49, 95% CI 1.13-1.96) was observed in men living in low SES neighbourhoods compared to those from middle SES neighbourhoods. The results were confirmed using Laplace regression; the time until the first 10% of the men in low SES neighbourhoods died was 1.45 (95% CI 0.48-2.42) years shorter than for the men in middle SES neighbourhoods. Conclusions: Increased rates of heart disease and subsequent mortality among adults in deprived neighbourhoods raise important clinical and public health concerns. These findings could serve as an aid to policy-makers when allocating resources in primary health care settings as well as to clinicians who encounter patients in deprived neighbourhoods. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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