Individual-Level Socioeconomic Position and Long-Term Prognosis in Danish Heart-Transplant Recipients

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  • Rikke E. Mols
  • Brian B. Løgstrup
  • István Bakos
  • Erzsébet Horváth-Puhó
  • Bo Christensen
  • Christoffer T. Witt
  • Morten Schmidt
  • Gustafsson, Finn
  • Hans Eiskjær

Socioeconomic deprivation can limit access to healthcare. Important gaps persist in the understanding of how individual indicators of socioeconomic disadvantage may affect clinical outcomes after heart transplantation. We sought to examine the impact of individual-level socioeconomic position (SEP) on prognosis of heart-transplant recipients. A population-based study including all Danish first-time heart-transplant recipients (n = 649) was conducted. Data were linked across complete national health registers. Associations were evaluated between SEP and all-cause mortality and first-time major adverse cardiovascular event (MACE) during follow-up periods. The half-time survival was 15.6 years (20-year period). In total, 330 (51%) of recipients experienced a first-time cardiovascular event and the most frequent was graft failure (42%). Both acute myocardial infarction and cardiac arrest occurred in ≤5 of recipients. Low educational level was associated with increased all-cause mortality 10–20 years post-transplant (adjusted hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.19–3.19). During 1–10 years post-transplant, low educational level (adjusted HR 1.66, 95% CI 1.14–2.43) and low income (adjusted HR 1.81, 95% CI 1.02–3.22) were associated with a first-time MACE. In a country with free access to multidisciplinary team management, low levels of education and income were associated with a poorer prognosis after heart transplantation.

OriginalsprogEngelsk
Artikelnummer10976
TidsskriftTransplant International
Vol/bind36
Antal sider9
ISSN0934-0874
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This study was supported by grants from The Karen Elise Jensen Foundation (July 2019) and The Helse Foundation (20-B-0155). The sponsor had no role in study design, data collection, analysis or interpretation of the data, writing of the manuscript, or in the decision to submit the manuscript for publication.

Publisher Copyright:
Copyright © 2023 Mols, Løgstrup, Bakos, Horváth-Puhó, Christensen, Witt, Schmidt, Gustafsson and Eiskjær.

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