Educational status affects prognosis of patients with heart failure with reduced ejection fraction: A post-hoc analysis from the WARCEF trial.



Corica, Bernadette ORCID: 0000-0001-9460-4435, Romiti, Giulio Francesco, Simoni, Amalie Helme, Mei, Davide Antonio, Bucci, Tommaso ORCID: 0000-0003-2895-6234, Thompson, John LP, Qian, Min, Homma, Shunichi, Proietti, Marco ORCID: 0000-0003-1452-2478, Lip, Gregory YH ORCID: 0000-0002-7566-1626
et al (show 1 more authors) (2024) Educational status affects prognosis of patients with heart failure with reduced ejection fraction: A post-hoc analysis from the WARCEF trial. European journal of clinical investigation, 54 (5). e14152-e14152.

[thumbnail of 2024 - Corica - Educational status affects prognosis of patients with heart failure with reduced.pdf] Text
2024 - Corica - Educational status affects prognosis of patients with heart failure with reduced.pdf - Open Access published version

Download (554kB) | Preview

Abstract

<h4>Aims</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>Compared to patients with high educational levels, those with low educational status had worse prognosis. SDOH should be considered in patients with HFrEF.<h4>Clinical trial registration</h4>NCT00041938.

Item Type: Article
Uncontrolled Keywords: WARCEF Investigators
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 29 Feb 2024 11:51
Last Modified: 22 Apr 2024 02:41
DOI: 10.1111/eci.14152
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3179008