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Association between socio-economic status and incident atrial fibrillation


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Ramkumar, S, Ochi, A, Yang, H, Nerlekar, N, D'Elia, N, Potter, EL, Murray, IC, Nattraj, N, Wang, Y and Marwick, TH ORCID: 0000-0001-9065-0899 2018 , 'Association between socio-economic status and incident atrial fibrillation' , Internal Medicine Journal , pp. 1-18 , doi: 10.1111/imj.14214.

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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 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 Type: Article
Authors/Creators: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
Keywords: atrial fibrillation, screening, socioeconomic status
Journal or Publication Title: Internal Medicine Journal
Publisher: Blackwell Publishing Asia
ISSN: 1444-0903
DOI / ID Number: 10.1111/imj.14214
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