Abstract:
:Background Low income and short education have been found to be independently associated with inferior survival after coronary artery bypass grafting (CABG), whereas the use of secondary prevention medications is associated with improved survival. We investigated whether underusage of secondary prevention medications contributes to the inferior long-term survival in CABG patients with a low income and short education. Methods and Results Patients who underwent CABG in Sweden between 2006 to 2015 and survived at least 6 months after discharge (n=28 448) were included in a population-based cohort study. Individual patient data from 5 national registries, including the SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies) registry, covering dispensing of secondary prevention medications (statins, platelet inhibitors, β-blockers, and RAAS inhibitors), socioeconomic factors, patient characteristics, comorbidity, and long-term mortaity were merged. All-cause mortality risk was estimated using multivariable Cox regression models adjusted for patient characteristics, baseline comorbidities, time-updated secondary prevention medications, and socioeconomic status. Long-term mortality was higher in patients with a low income and short education. Statins and platelet inhibitors were dispensed less often to patients with a low income, both at baseline and after 8 years. The decline in dispensing over time was steeper for low-income patients. Short education was not associated with reduced dispensing of any secondary prevention medication. Use of statins (adjusted hazard ratio=0.57 [95% CI, 0.53-0.61]), RAAS inhibitors (adjusted hazard ratio=0.78 [0.73-0.84]), and platelet inhibitors (adjusted hazard ratio=0.74 [0.68-0.80]) were associated with reduced long-term mortality irrespective of socioeconomic status. Conclusions Secondary prevention medications are dispensed less often after CABG to patients with low income. Underusage of secondary prevention medications after CABG is associated with increased mortality risk independently of income and extent of education.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Nielsen SJ,Karlsson M,Björklund E,Martinsson A,Hansson EC,Malm CJ,Pivodic A,Jeppsson Adoi
10.1161/JAHA.119.015491subject
Has Abstractpub_date
2020-03-03 00:00:00pages
e015491issue
5issn
2047-9980journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Hemorrhagic risk assessment is a crucial issue in patients with nonvalvular atrial fibrillation (NVAF) who are receiving oral anticoagulant therapy (OAT). Our aim was to analyze the relationship between vitamin E, which possesses anticoagulant properties, and bleeding events in NVAF patients. METHODS AND RE...
journal_title:Journal of the American Heart Association
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doi:10.1161/JAHA.113.000364
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abstract::Background The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial failed to show a reduction in hard clinical end points with an early invasive strategy in stable ischemic heart disease (SIHD). However, the influence of left main disease and high-risk coronary...
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abstract::[This corrects the article DOI: 10.1161/JAHA.117.005967.]. ...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章,已发布勘误
doi:10.1161/JAHA.117.004215
更新日期:2017-12-23 00:00:00
abstract:BACKGROUND:Galectin-3 may play a role in cardiac and noncardiac fibrosis, and elevated circulating levels of this protein predict adverse outcomes in patients with heart failure who do not have congenital heart disease. We investigated galectin-3 in adults with single-ventricle Fontan circulation, patients who are pron...
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pub_type: 杂志文章
doi:10.1161/JAHA.115.002706
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pub_type: 杂志文章
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更新日期:2014-10-20 00:00:00
abstract::Background Stroke is a leading cause of death and disability in the Middle East. Data on the uptake of evidence-based practices are limited in the region. We aimed to examine patterns of stroke presentation, management, and outcomes at public Palestinian hospitals. Methods and Results Comprehensive data from all patie...
journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.010778
更新日期:2018-11-20 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of the American Heart Association
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.005897
更新日期:2017-07-19 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.117.005715
更新日期:2017-06-24 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,meta分析,评审
doi:10.1161/JAHA.116.005042
更新日期:2017-03-29 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
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更新日期:2019-10-15 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.010653
更新日期:2018-11-20 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.118.009098
更新日期:2018-11-06 00:00:00
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journal_title:Journal of the American Heart Association
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journal_title:Journal of the American Heart Association
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journal_title:Journal of the American Heart Association
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更新日期:2014-10-23 00:00:00
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更新日期:2021-01-05 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-03-23 00:00:00
abstract::See Article Shah et al. ...
journal_title:Journal of the American Heart Association
pub_type: 评论,社论
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更新日期:2019-06-04 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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更新日期:2016-12-05 00:00:00
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