PT  - JOURNAL ARTICLE
AU  - Klaus K Witte
AU  - Peysh A Patel
AU  - Andrew M N Walker
AU  - Clyde B Schechter
AU  - Michael Drozd
AU  - Anshuman Sengupta
AU  - Rowenna Byrom
AU  - Lorraine C Kearney
AU  - Robert J Sapsford
AU  - Mark T Kearney
AU  - Richard M Cubbon
TI  - Socioeconomic deprivation and mode-specific outcomes in patients with chronic heart failure
AID  - 10.1136/heartjnl-2017-312539
DP  - 2018 Jun 01
TA  - Heart
PG  - 993--998
VI  - 104
IP  - 12
4099  - http://heart.bmj.com/content/104/12/993.short
4100  - http://heart.bmj.com/content/104/12/993.full
SO  - Heart2018 Jun 01; 104
AB  - Objective To characterise the association between socioeconomic deprivation and adverse outcomes in patients with chronic heart failure (CHF).Methods We prospectively observed 1802 patients with CHF and left ventricular ejection fraction (LVEF) ≤45%, recruited in four UK hospitals between 2006 and 2014. We assessed the association between deprivation defined by the UK Index of Multiple Deprivation (IMD) and: mode-specific mortality (mean follow-up 4 years); mode-specific hospitalisation; and the cumulative duration of hospitalisation (after 1 year).Results A 45-point difference in mean IMD score was noted between patients residing in the least and most deprived quintiles of geographical regions. Deprivation was associated with age, sex and comorbidity, but not CHF symptoms, LVEF or prescribed drug therapy. IMD score was associated with the risk of age-sex adjusted all-cause mortality (6% higher risk per 10-unit increase in IMD score; 95% CI 2% to 10%; P=0.004), and non-cardiovascular mortality (9% higher risk per 10-unit increase in IMD score; 95% CI 3% to 16%; P=0.003), but not cardiovascular mortality. All-cause, but not heart failure-specific, hospitalisation was also more common in the most deprived patients. Overall, patients spent a cumulative 3.3 days in hospital during 1 year of follow-up, with IMD score being associated with the age-sex adjusted cumulative duration of hospitalisations (4% increase in duration per 10-unit increase in IMD score; 95% CI 3% to 6%; P<0.0005).Conclusions Socioeconomic deprivation in people with CHF is linked to increased risk of death and hospitalisation due to an excess of non-cardiovascular events.