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Association between socio-economic status and incident atrial fibrillation

Citation

Ramkumar, S and Ochi, A and Yang, H and Nerlekar, N and D'Elia, N and Potter, EL and Murray, IC and Nattraj, N and Wang, Y and Marwick, TH, Association between socio-economic status and incident atrial fibrillation, Internal Medicine Journal pp. 1-18. ISSN 1444-0903 (2018) [Refereed Article]


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This article is protected by copyright. All rights reserved. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This is the peer reviewed version which has been published in final form at:

DOI: doi:10.1111/imj.14214

Abstract

Background: Low socio-economic status is associated with cardiovascular diseases, and an association with atrial fibrillation (AF) could guide screening. We investigated if indices of disadvantage (IAD), education/occupation (IEO) and economic resources (IER) were associated with incident AF, independent of risk factors and cardiac function.

Methods: We studied community-based participants aged ≥65 years with AF risk factors (n=379, age 70 4 years, 45% men). The CHARGE-AF score (a well validated AF risk score) was used to assess 5-year risk of developing AF. Participants also had baseline echocardiograms. IAD, IEO and IER were obtained from the 2011 Socio-Economic Indexes for Areas (SEIFA) score, in which higher decile ranks indicate more advantaged areas. Patients were followed up for incident AF(median 21 (range 5-31) months), with AF diagnosed by clinical review including 12 lead ECG, as well as single lead portable ECG monitoring used to record 60 second ECG tracings five times/day for one week. Cox proportional hazards models were used to assess the association between socio-economic status and incident AF.

Results: Subjects with AF (n=50, 13%) were more likely to be male (64% vs.42%, p=0.003) and had higher CHARGE-AF score (median 7.1% (5.2-12.8%) vs. 5.3% (3.3-8.6%), p<0.001). Areas with lower socio-economic status (IAD and IEO) had a higher risk of incident AF independent of LV function and CHARGE-AF score (HR for IAD 1.16, 95% C.I 1.05-1.29, p=0.005 and HR for IEO 1.18, 95% C.I 1.07-1.30, p=0.001).

Conclusion: Regional socio-economic status is associated with risk of incident AF, independent of LV function and clinical risk. This association might permit better regional targeting of prevention.

Item Details

Item Type:Refereed Article
Keywords:atrial fibrillation, screening, socioeconomic status
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
UTAS Author:Ochi, A (Miss Ayame Ochi)
UTAS Author:Yang, H (Ms Hilda Yang)
UTAS Author:Murray, IC (Miss Isabella Murray)
UTAS Author:Nattraj, N (Miss Nishee Nattraj)
UTAS Author:Wang, Y (Ms Ying Wang)
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:133399
Year Published:2018
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-06-26
Last Modified:2019-08-05
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