Educational status affects prognosis of patients with heart failure with reduced ejection fraction : A post-hoc analysis from the WARCEF trial
© 2024 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation..
AIMS: The influence of social determinants of health (SDOH) on the prognosis of Heart Failure and reduced Ejection Fraction (HFrEF) is increasingly reported. We aim to evaluate the contribution of educational status on outcomes in patients with HFrEF.
METHODS: We used data from the WARCEF trial, which randomized HFrEF patients with sinus rhythm to receive Warfarin or Aspirin; educational status of patients enrolled was collected at baseline. We defined three levels of education: low, medium and high level, according to the highest qualification achieved or highest school grade attended. We analysed the impact of the educational status on the risk of the primary composite outcome of all-cause death, ischemic stroke (IS) and intracerebral haemorrhage (ICH); components of the primary outcome were also analysed as secondary outcomes.
RESULTS: 2295 patients were included in this analysis; of these, 992 (43.2%) had a low educational level, 947 (41.3%) had a medium education level and the remaining 356 (15.5%) showed a high educational level. Compared to patients with high educational level, those with low educational status showed a high risk of the primary composite outcome (adjusted hazard ratio [aHR]: 1.31, 95% confidence intervals [CI] 1.02-1.69); a non-statistically significant association was observed in those with medium educational level (aHR: 1.20, 95%CI: .93-1.55). Similar results were observed for all-cause death, while no statistically significant differences were observed for IS or ICH.
CONCLUSION: Compared to patients with high educational levels, those with low educational status had worse prognosis. SDOH should be considered in patients with HFrEF.
CLINICAL TRIAL REGISTRATION: NCT00041938.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
|---|---|
| Enthalten in: |
European journal of clinical investigation - 54(2024), 5 vom: 15. Apr., Seite e14152 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Corica, Bernadette [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
5Q7ZVV76EI |
|---|
| Anmerkungen: |
Date Completed 17.04.2024 Date Revised 17.04.2024 published: Print-Electronic ClinicalTrials.gov: NCT00041938 Citation Status MEDLINE |
|---|
| doi: |
10.1111/eci.14152 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366964577 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366964577 | ||
| 003 | DE-627 | ||
| 005 | 20240417232356.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240114s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/eci.14152 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1378.xml |
| 035 | |a (DE-627)NLM366964577 | ||
| 035 | |a (NLM)38205865 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Corica, Bernadette |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Educational status affects prognosis of patients with heart failure with reduced ejection fraction |b A post-hoc analysis from the WARCEF trial |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 17.04.2024 | ||
| 500 | |a Date Revised 17.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT00041938 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation. | ||
| 520 | |a AIMS: The influence of social determinants of health (SDOH) on the prognosis of Heart Failure and reduced Ejection Fraction (HFrEF) is increasingly reported. We aim to evaluate the contribution of educational status on outcomes in patients with HFrEF | ||
| 520 | |a METHODS: We used data from the WARCEF trial, which randomized HFrEF patients with sinus rhythm to receive Warfarin or Aspirin; educational status of patients enrolled was collected at baseline. We defined three levels of education: low, medium and high level, according to the highest qualification achieved or highest school grade attended. We analysed the impact of the educational status on the risk of the primary composite outcome of all-cause death, ischemic stroke (IS) and intracerebral haemorrhage (ICH); components of the primary outcome were also analysed as secondary outcomes | ||
| 520 | |a RESULTS: 2295 patients were included in this analysis; of these, 992 (43.2%) had a low educational level, 947 (41.3%) had a medium education level and the remaining 356 (15.5%) showed a high educational level. Compared to patients with high educational level, those with low educational status showed a high risk of the primary composite outcome (adjusted hazard ratio [aHR]: 1.31, 95% confidence intervals [CI] 1.02-1.69); a non-statistically significant association was observed in those with medium educational level (aHR: 1.20, 95%CI: .93-1.55). Similar results were observed for all-cause death, while no statistically significant differences were observed for IS or ICH | ||
| 520 | |a CONCLUSION: Compared to patients with high educational levels, those with low educational status had worse prognosis. SDOH should be considered in patients with HFrEF | ||
| 520 | |a CLINICAL TRIAL REGISTRATION: NCT00041938 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a HFrEF | |
| 650 | 4 | |a educational level | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a social determinants of health | |
| 650 | 7 | |a Warfarin |2 NLM | |
| 650 | 7 | |a 5Q7ZVV76EI |2 NLM | |
| 700 | 1 | |a Romiti, Giulio Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Simoni, Amalie Helme |e verfasserin |4 aut | |
| 700 | 1 | |a Mei, Davide Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Bucci, Tommaso |e verfasserin |4 aut | |
| 700 | 1 | |a Thompson, John L P |e verfasserin |4 aut | |
| 700 | 1 | |a Qian, Min |e verfasserin |4 aut | |
| 700 | 1 | |a Homma, Shunichi |e verfasserin |4 aut | |
| 700 | 1 | |a Proietti, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Lip, Gregory Y H |e verfasserin |4 aut | |
| 700 | 0 | |a WARCEF Investigators |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of clinical investigation |d 1970 |g 54(2024), 5 vom: 15. Apr., Seite e14152 |w (DE-627)NLM000003107 |x 1365-2362 |7 nnns |
| 773 | 1 | 8 | |g volume:54 |g year:2024 |g number:5 |g day:15 |g month:04 |g pages:e14152 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/eci.14152 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 54 |j 2024 |e 5 |b 15 |c 04 |h e14152 | ||