Socioeconomic factors and mortality in diastolic heart failure

BackgroundMortality in patients with heart failure with preserved ejection fraction (HFPEF) has remained stable over recent decades. Few studies have explored prognostic characteristics specifically in HFPEF, and none of them has assessed the potential impact of socioeconomic factors. We aimed to evaluate the impact of socioeconomic factors on all-cause and cardiovascular mortality in HFPEF patients. Materials and methodsWe used data from the French ODIN cohort. All patients with heart failure and a left ventricular ejection fraction (LVEF) >45%, included in ODIN between July 2007 and July 2010, were eligible here. Socioeconomic, demographic, clinical, biological and therapeutic data were collected at inclusion. The endpoints were all-cause and cardiovascular mortality between inclusion and 30 September 2011. The impact of patient socioeconomic characteristics on mortality was assessed using Cox regression models. ResultsOf 575 HFPEF patients considered, 586% were male; their mean age was 711135years, and their mean LVEF was 581+/- 85%. After adjustment for confounders, living alone and limitations on activities of daily living were associated with all-cause mortality [HR=177, 95%CI(111-281) and 261(135-503), respectively] and cardiovascular mortality [226 (124-410) and 316 (133-754), respectively]. Having a professional occupation was associated with a lower cardiovascular mortality only [037(015-094)]. ConclusionsPoor social conditions impair survival in patients with HFPEF. These findings may shed new light on how best to detect HFPEF patients with high health-care needs.