Socioeconomic Status and Outcomes in Heart Failure With Reduced Ejection Fraction From Asia
Little 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. We investigated the association of both patient-level (household income, education levels) and country-level (r...
Gespeichert in:
| Veröffentlicht in: | Circulation Cardiovascular quality and outcomes 2021-04, Vol.14 (4), p.e006962-e006962 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e006962 |
|---|---|
| container_issue | 4 |
| container_start_page | e006962 |
| container_title | Circulation Cardiovascular quality and outcomes |
| container_volume | 14 |
| creator | Teng, Tiew-Hwa K. Tay, Wan Ting Richards, Arthur Mark Chew, Timothy Shi Ming Anand, Inder Ouwerkerk, Wouter Chandramouli, Chanchal Huang, Weiting Lawson, Claire A. Kadam, Umesh T. Yap, Jonathan Lim, Shirlynn Hung, Chung-Lieh MacDonald, Michael Ross Loh, Seet Yoong Shimizu, Wataru Tromp, Jasper Lam, Carolyn Su Ping |
| description | Little 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.
We 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).
Among 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 ( |
| doi_str_mv | 10.1161/CIRCOUTCOMES.120.006962 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_pubmed_primary_33757307</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2504777036</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4076-6bb707e969aa5240fac1cb3cbc7bcf7d656f2feb48e4bfa3967adcad76700a6a3</originalsourceid><addsrcrecordid>eNpNkU1r3DAQhkVpaD7av9Dq2Iu3I0uW6mMwu00gZSGbkEMPYiyPWaW2lUo2of8-CpuEHIaZw_POwDOMfROwEkKLH83ldbO9vWm2v9e7lShhBaBrXX5gJ6JWojAGqo_v5mN2mtJ9ZmSp5Sd2LKWpjARzwv7sgvOBXJjC6B3fzTgviePU8e0yuzBS4n7iF4Rx5hv0wxKJ3_l5z6-pWxx1fH1PbvZh4puIr0MY-Xny-Jkd9Tgk-vLSz9jtZn3TXBRX21-XzflV4RQYXei2NWCo1jViVSro0QnXStc607redLrSfdlTq36SanuUtTbYOeyMNgCoUZ6x74e9DzH8WyjNdvTJ0TDgRGFJtqxAmaxB6oyaA-piSClSbx-iHzH-twLss1n73qzNZu3BbE5-fTmytCN1b7lXlRlQB-AxDDPF9HdYHinaPeEw7y2IDKpaFyWUAhQAFLnyQ54AazeGZQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2504777036</pqid></control><display><type>article</type><title>Socioeconomic Status and Outcomes in Heart Failure With Reduced Ejection Fraction From Asia</title><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Teng, Tiew-Hwa K. ; Tay, Wan Ting ; Richards, Arthur Mark ; Chew, Timothy Shi Ming ; Anand, Inder ; Ouwerkerk, Wouter ; Chandramouli, Chanchal ; Huang, Weiting ; Lawson, Claire A. ; Kadam, Umesh T. ; Yap, Jonathan ; Lim, Shirlynn ; Hung, Chung-Lieh ; MacDonald, Michael Ross ; Loh, Seet Yoong ; Shimizu, Wataru ; Tromp, Jasper ; Lam, Carolyn Su Ping</creator><creatorcontrib>Teng, Tiew-Hwa K. ; Tay, Wan Ting ; Richards, Arthur Mark ; Chew, Timothy Shi Ming ; Anand, Inder ; Ouwerkerk, Wouter ; Chandramouli, Chanchal ; Huang, Weiting ; Lawson, Claire A. ; Kadam, Umesh T. ; Yap, Jonathan ; Lim, Shirlynn ; Hung, Chung-Lieh ; MacDonald, Michael Ross ; Loh, Seet Yoong ; Shimizu, Wataru ; Tromp, Jasper ; Lam, Carolyn Su Ping ; ASIAN-HF investigators</creatorcontrib><description>Little 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.
We 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).
Among 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 (<US$1000); and 29.5% had no/only primary education. The largest disparity in treatment across regional income levels pertained to β-blocker and device therapies, with patients from low-income regions being less likely to receive these treatments compared with those from high-income regions and even greater disparity among patients with lower education status and lower household income within each regional income strata. Higher country- and patient-level socioeconomic indicators related to higher quality of life scores and lower risk of the primary composite outcome. Notably, we found a significant interaction between regional income level and both household income and education status (
<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.
These 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. Registration: URL: https://clinicaltrials.gov; Unique Identifier: NCT01633398.</description><identifier>ISSN: 1941-7705</identifier><identifier>ISSN: 1941-7713</identifier><identifier>EISSN: 1941-7705</identifier><identifier>DOI: 10.1161/CIRCOUTCOMES.120.006962</identifier><identifier>PMID: 33757307</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><ispartof>Circulation Cardiovascular quality and outcomes, 2021-04, Vol.14 (4), p.e006962-e006962</ispartof><rights>American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4076-6bb707e969aa5240fac1cb3cbc7bcf7d656f2feb48e4bfa3967adcad76700a6a3</citedby><cites>FETCH-LOGICAL-c4076-6bb707e969aa5240fac1cb3cbc7bcf7d656f2feb48e4bfa3967adcad76700a6a3</cites><orcidid>0000-0002-8431-9961 ; 0000-0003-0127-5236 ; 0000-0003-3501-3592 ; 0000-0001-9941-8973 ; 0000-0001-8256-902X ; 0000-0003-2397-5946 ; 0000-0002-1151-2357 ; 0000-0002-5020-3645 ; 0000-0003-1308-4963 ; 0000-0002-2858-3493 ; 0000-0003-1903-0018 ; 0000-0002-2023-8177 ; 0000-0002-2000-9358 ; 0000-0002-4433-2977 ; 0000-0003-3453-2374</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33757307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Teng, Tiew-Hwa K.</creatorcontrib><creatorcontrib>Tay, Wan Ting</creatorcontrib><creatorcontrib>Richards, Arthur Mark</creatorcontrib><creatorcontrib>Chew, Timothy Shi Ming</creatorcontrib><creatorcontrib>Anand, Inder</creatorcontrib><creatorcontrib>Ouwerkerk, Wouter</creatorcontrib><creatorcontrib>Chandramouli, Chanchal</creatorcontrib><creatorcontrib>Huang, Weiting</creatorcontrib><creatorcontrib>Lawson, Claire A.</creatorcontrib><creatorcontrib>Kadam, Umesh T.</creatorcontrib><creatorcontrib>Yap, Jonathan</creatorcontrib><creatorcontrib>Lim, Shirlynn</creatorcontrib><creatorcontrib>Hung, Chung-Lieh</creatorcontrib><creatorcontrib>MacDonald, Michael Ross</creatorcontrib><creatorcontrib>Loh, Seet Yoong</creatorcontrib><creatorcontrib>Shimizu, Wataru</creatorcontrib><creatorcontrib>Tromp, Jasper</creatorcontrib><creatorcontrib>Lam, Carolyn Su Ping</creatorcontrib><creatorcontrib>ASIAN-HF investigators</creatorcontrib><title>Socioeconomic Status and Outcomes in Heart Failure With Reduced Ejection Fraction From Asia</title><title>Circulation Cardiovascular quality and outcomes</title><addtitle>Circ Cardiovasc Qual Outcomes</addtitle><description>Little 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.
We 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).
Among 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 (<US$1000); and 29.5% had no/only primary education. The largest disparity in treatment across regional income levels pertained to β-blocker and device therapies, with patients from low-income regions being less likely to receive these treatments compared with those from high-income regions and even greater disparity among patients with lower education status and lower household income within each regional income strata. Higher country- and patient-level socioeconomic indicators related to higher quality of life scores and lower risk of the primary composite outcome. Notably, we found a significant interaction between regional income level and both household income and education status (
<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.
These 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. Registration: URL: https://clinicaltrials.gov; Unique Identifier: NCT01633398.</description><issn>1941-7705</issn><issn>1941-7713</issn><issn>1941-7705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpNkU1r3DAQhkVpaD7av9Dq2Iu3I0uW6mMwu00gZSGbkEMPYiyPWaW2lUo2of8-CpuEHIaZw_POwDOMfROwEkKLH83ldbO9vWm2v9e7lShhBaBrXX5gJ6JWojAGqo_v5mN2mtJ9ZmSp5Sd2LKWpjARzwv7sgvOBXJjC6B3fzTgviePU8e0yuzBS4n7iF4Rx5hv0wxKJ3_l5z6-pWxx1fH1PbvZh4puIr0MY-Xny-Jkd9Tgk-vLSz9jtZn3TXBRX21-XzflV4RQYXei2NWCo1jViVSro0QnXStc607redLrSfdlTq36SanuUtTbYOeyMNgCoUZ6x74e9DzH8WyjNdvTJ0TDgRGFJtqxAmaxB6oyaA-piSClSbx-iHzH-twLss1n73qzNZu3BbE5-fTmytCN1b7lXlRlQB-AxDDPF9HdYHinaPeEw7y2IDKpaFyWUAhQAFLnyQ54AazeGZQ</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Teng, Tiew-Hwa K.</creator><creator>Tay, Wan Ting</creator><creator>Richards, Arthur Mark</creator><creator>Chew, Timothy Shi Ming</creator><creator>Anand, Inder</creator><creator>Ouwerkerk, Wouter</creator><creator>Chandramouli, Chanchal</creator><creator>Huang, Weiting</creator><creator>Lawson, Claire A.</creator><creator>Kadam, Umesh T.</creator><creator>Yap, Jonathan</creator><creator>Lim, Shirlynn</creator><creator>Hung, Chung-Lieh</creator><creator>MacDonald, Michael Ross</creator><creator>Loh, Seet Yoong</creator><creator>Shimizu, Wataru</creator><creator>Tromp, Jasper</creator><creator>Lam, Carolyn Su Ping</creator><general>American Heart Association, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8431-9961</orcidid><orcidid>https://orcid.org/0000-0003-0127-5236</orcidid><orcidid>https://orcid.org/0000-0003-3501-3592</orcidid><orcidid>https://orcid.org/0000-0001-9941-8973</orcidid><orcidid>https://orcid.org/0000-0001-8256-902X</orcidid><orcidid>https://orcid.org/0000-0003-2397-5946</orcidid><orcidid>https://orcid.org/0000-0002-1151-2357</orcidid><orcidid>https://orcid.org/0000-0002-5020-3645</orcidid><orcidid>https://orcid.org/0000-0003-1308-4963</orcidid><orcidid>https://orcid.org/0000-0002-2858-3493</orcidid><orcidid>https://orcid.org/0000-0003-1903-0018</orcidid><orcidid>https://orcid.org/0000-0002-2023-8177</orcidid><orcidid>https://orcid.org/0000-0002-2000-9358</orcidid><orcidid>https://orcid.org/0000-0002-4433-2977</orcidid><orcidid>https://orcid.org/0000-0003-3453-2374</orcidid></search><sort><creationdate>20210401</creationdate><title>Socioeconomic Status and Outcomes in Heart Failure With Reduced Ejection Fraction From Asia</title><author>Teng, Tiew-Hwa K. ; Tay, Wan Ting ; Richards, Arthur Mark ; Chew, Timothy Shi Ming ; Anand, Inder ; Ouwerkerk, Wouter ; Chandramouli, Chanchal ; Huang, Weiting ; Lawson, Claire A. ; Kadam, Umesh T. ; Yap, Jonathan ; Lim, Shirlynn ; Hung, Chung-Lieh ; MacDonald, Michael Ross ; Loh, Seet Yoong ; Shimizu, Wataru ; Tromp, Jasper ; Lam, Carolyn Su Ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4076-6bb707e969aa5240fac1cb3cbc7bcf7d656f2feb48e4bfa3967adcad76700a6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teng, Tiew-Hwa K.</creatorcontrib><creatorcontrib>Tay, Wan Ting</creatorcontrib><creatorcontrib>Richards, Arthur Mark</creatorcontrib><creatorcontrib>Chew, Timothy Shi Ming</creatorcontrib><creatorcontrib>Anand, Inder</creatorcontrib><creatorcontrib>Ouwerkerk, Wouter</creatorcontrib><creatorcontrib>Chandramouli, Chanchal</creatorcontrib><creatorcontrib>Huang, Weiting</creatorcontrib><creatorcontrib>Lawson, Claire A.</creatorcontrib><creatorcontrib>Kadam, Umesh T.</creatorcontrib><creatorcontrib>Yap, Jonathan</creatorcontrib><creatorcontrib>Lim, Shirlynn</creatorcontrib><creatorcontrib>Hung, Chung-Lieh</creatorcontrib><creatorcontrib>MacDonald, Michael Ross</creatorcontrib><creatorcontrib>Loh, Seet Yoong</creatorcontrib><creatorcontrib>Shimizu, Wataru</creatorcontrib><creatorcontrib>Tromp, Jasper</creatorcontrib><creatorcontrib>Lam, Carolyn Su Ping</creatorcontrib><creatorcontrib>ASIAN-HF investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Cardiovascular quality and outcomes</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Teng, Tiew-Hwa K.</au><au>Tay, Wan Ting</au><au>Richards, Arthur Mark</au><au>Chew, Timothy Shi Ming</au><au>Anand, Inder</au><au>Ouwerkerk, Wouter</au><au>Chandramouli, Chanchal</au><au>Huang, Weiting</au><au>Lawson, Claire A.</au><au>Kadam, Umesh T.</au><au>Yap, Jonathan</au><au>Lim, Shirlynn</au><au>Hung, Chung-Lieh</au><au>MacDonald, Michael Ross</au><au>Loh, Seet Yoong</au><au>Shimizu, Wataru</au><au>Tromp, Jasper</au><au>Lam, Carolyn Su Ping</au><aucorp>ASIAN-HF investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Socioeconomic Status and Outcomes in Heart Failure With Reduced Ejection Fraction From Asia</atitle><jtitle>Circulation Cardiovascular quality and outcomes</jtitle><addtitle>Circ Cardiovasc Qual Outcomes</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>14</volume><issue>4</issue><spage>e006962</spage><epage>e006962</epage><pages>e006962-e006962</pages><issn>1941-7705</issn><issn>1941-7713</issn><eissn>1941-7705</eissn><abstract>Little 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.
We 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).
Among 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 (<US$1000); and 29.5% had no/only primary education. The largest disparity in treatment across regional income levels pertained to β-blocker and device therapies, with patients from low-income regions being less likely to receive these treatments compared with those from high-income regions and even greater disparity among patients with lower education status and lower household income within each regional income strata. Higher country- and patient-level socioeconomic indicators related to higher quality of life scores and lower risk of the primary composite outcome. Notably, we found a significant interaction between regional income level and both household income and education status (
<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.
These 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. Registration: URL: https://clinicaltrials.gov; Unique Identifier: NCT01633398.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>33757307</pmid><doi>10.1161/CIRCOUTCOMES.120.006962</doi><orcidid>https://orcid.org/0000-0002-8431-9961</orcidid><orcidid>https://orcid.org/0000-0003-0127-5236</orcidid><orcidid>https://orcid.org/0000-0003-3501-3592</orcidid><orcidid>https://orcid.org/0000-0001-9941-8973</orcidid><orcidid>https://orcid.org/0000-0001-8256-902X</orcidid><orcidid>https://orcid.org/0000-0003-2397-5946</orcidid><orcidid>https://orcid.org/0000-0002-1151-2357</orcidid><orcidid>https://orcid.org/0000-0002-5020-3645</orcidid><orcidid>https://orcid.org/0000-0003-1308-4963</orcidid><orcidid>https://orcid.org/0000-0002-2858-3493</orcidid><orcidid>https://orcid.org/0000-0003-1903-0018</orcidid><orcidid>https://orcid.org/0000-0002-2023-8177</orcidid><orcidid>https://orcid.org/0000-0002-2000-9358</orcidid><orcidid>https://orcid.org/0000-0002-4433-2977</orcidid><orcidid>https://orcid.org/0000-0003-3453-2374</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-7705 |
| ispartof | Circulation Cardiovascular quality and outcomes, 2021-04, Vol.14 (4), p.e006962-e006962 |
| issn | 1941-7705 1941-7713 1941-7705 |
| language | eng |
| recordid | cdi_pubmed_primary_33757307 |
| source | American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| title | Socioeconomic Status and Outcomes in Heart Failure With Reduced Ejection Fraction From Asia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-18T09%3A13%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Socioeconomic%20Status%20and%20Outcomes%20in%20Heart%20Failure%20With%20Reduced%20Ejection%20Fraction%20From%20Asia&rft.jtitle=Circulation%20Cardiovascular%20quality%20and%20outcomes&rft.au=Teng,%20Tiew-Hwa%20K.&rft.aucorp=ASIAN-HF%20investigators&rft.date=2021-04-01&rft.volume=14&rft.issue=4&rft.spage=e006962&rft.epage=e006962&rft.pages=e006962-e006962&rft.issn=1941-7705&rft.eissn=1941-7705&rft_id=info:doi/10.1161/CIRCOUTCOMES.120.006962&rft_dat=%3Cproquest_cross%3E2504777036%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2504777036&rft_id=info:pmid/33757307&rfr_iscdi=true |