Income and outcomes of patients with incident atrial fibrillation

Abstract

<p>Background <br></p><p>Socioeconomic disparities can be associated with adverse outcomes in patients with cardiovascular diseases. The impact of personal income on the outcomes of patients with atrial fibrillation (AF) is unclear.<br></p><p>Methods <br></p><p>Nationwide observational registry-based study on patients with incident AF in Finland during 2007-2018.<br></p><p>Results <br></p><p>203 154 patients (mean age 73.0 +/- 13.5; females 49.0%) were diagnosed with incident AF during the study period. Overall, 16 272 (8.0%) patients experienced first-ever ischaemic stroke and 63 420 (31.2%) died (mean follow-up 4.3 +/- 3.3 years). After adjusting for confounding factors, low personal income was associated with increased risk of overall mortality in all age strata and the incidence of first--ever stroke in patients aged <65 years and 65-74 years, but not in those >= 75 years. The magnitude of this effect was greatest in patients aged <65 years. After propensity score matching of patients <65 years in the lowest and highest quintiles of maximum personal annual income, at 10 years, those in the highest income quintile (<=(euro)54 000) had significantly lower risk of first--ever stroke (subdistribution HR 0.495, 95% CI 0.391 to 0.628) and overall mortality (HR 0.307, 95% CI 0.269 to 0.351) compared with patients in the lowest income quintile (<=(euro)12 000).<br></p><p>Conclusions <br></p><p>Personal annual income has a significant impact on the incidence of first-ever ischaemic stroke and overall mortality among patients with incident AF, particularly among patients of working age. Low-income indicate the need for intervention strategies to improve outcomes of AF.</p>