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133399 - Association between socio-economic status and incident atrial fibrillation.pdf (1.19 MB)

Association between socio-economic status and incident atrial fibrillation

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journal contribution
posted on 2023-05-20, 04:50 authored by Ramkumar, S, Ayame Ochi, Yang, H, Nerlekar, N, D'Elia, N, Potter, EL, Murray, IC, Nattraj, N, Wang, Y, Thomas MarwickThomas Marwick

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 < 0.001). Areas with lower socio-economic status (IAD and IEO) had a higher risk of incident AF independent of LV function and CHARGE-AF score (HR for IAD 1.16, 95% C.I 1.05-1.29, 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.


Publication title

Internal Medicine Journal






Menzies Institute for Medical Research


Blackwell Publishing Asia

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54 University St, P O Box 378, Carlton, Australia, Victoria, 3053

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