journal contribution posted on 23.06.2022, 10:58 authored by Tiew-Hwa K Teng, Wan Ting Tay, Arthur Mark Richards, Timothy Shi Ming Chew, Inder Anand, Wouter Ouwerkerk, Chanchal Chandramouli, Weiting Huang, Claire A Lawson, Umesh T Kadam, Jonathan Yap, Shirlynn Lim, Chung-Lieh Hung, Michael Ross MacDonald, Seet Yoong Loh, Wataru Shimizu, Jasper Tromp, Carolyn Su Ping Lam, ASIAN-HF investigators
BackgroundLittle is known regarding the impact of socioeconomic factors on the use of evidence-based therapies and outcomes in patients with heart failure with reduced ejection fraction across Asia.
MethodsWe investigated the association of both patient-level (household income, education levels) and country-level (regional income level by World Bank classification, income disparity by Gini index) socioeconomic indicators on use of guideline-directed therapy and clinical outcomes (composite of 1-year mortality or HF hospitalization, quality of life) in the prospective multinational ASIAN-HF study (Asian Sudden Cardiac Death in Heart Failure).
ResultsAmong 4540 patients (mean age: 60±13 years, 23% women) with heart failure with reduced ejection fraction, 39% lived in low-income regions; 34% in regions with high-income disparity (Gini ≥42.8%); 64.4% had low monthly household income (Pinteraction <0.001 for both), where the association of low household income and low education status with poor outcomes was more pronounced in high-income compared with lower income regions.
ConclusionsThese findings highlight the importance of socioeconomic determinants among patients with heart failure in Asia and suggest that attention should be paid to address disparities in access to care among the poor and less educated, including those from wealthy regions.
RegistrationURL: https://clinicaltrials.gov; Unique Identifier: NCT01633398.
CitationCirculation: Cardiovascular Quality and Outcomes. 2021;14:e006962
Author affiliationDepartment of Cardiovascular Sciences, University of Leicester
VersionAM (Accepted Manuscript)
Published inCirculation: Cardiovascular Quality and Outcomes
PublisherAmerican Heart Association
Spatial coverageUnited States