{"doi":"10.17615/a6nv-3t33","title":"Impact of Socioeconomic Status on Mortality and Readmission in Patients With Heart Failure With Reduced Ejection Fraction: The ARIC Study","abstract":"BACKGROUND: Low socioeconomic status (SES) is associated with a higher risk of heart failure (HF). The contribution of indi-vidual and neighborhood SES to the prognosis and quality of care for HF with reduced ejection fraction is not clear yet has important implications. METHODS AND RESULTS: We examined 728 participants of the ARIC (Atherosclerosis Risk in Communities) study (mean age, 78.2 years; 34% Black participants; 46% women) hospitalized with HF with reduced ejection fraction (ejection fraction <50%) between 2005 and 2018. We assessed associations between education, income, and area deprivation index with mortality and HF readmission using multivariable Cox models. We also evaluated the use of guideline-directed medical therapy (optimal: ≥3 of ß-blockers, mineralocorticoid receptor antagonist, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers; acceptable: at least 2) at discharge. During a median follow-up of 3.2 years, 58.7% were readmitted with HF, and 74.0% died. Low income was associated with higher mortality (hazard ratio [HR], 1.52 [95% CI, 1.14– 2.04]) and readmission (HR, 1.45 [95% CI, 1.04– 2.03]). Similarly, low education was associated with mortality (HR, 1.27 [95% CI, 1.01–1.59]) and readmission (HR, 1.62 [95% CI, 1.24– 2.12]). The highest versus lowest area deprivation index quartile was associated with readmission (HR, 1.69 [95% CI, 1.11– 2.58]) but not necessarily with mortality. The prevalence of optimal guideline-directed medical therapy and acceptable guideline-directed medical therapy was 5.5% and 54.4%, respectively, but did not significantly differ by SES. CONCLUSIONS: Among patients hospitalized with HF with reduced ejection fraction, low SES was independently associated with mortality and HF readmission. A targeted secondary prevention approach that focuses intensive efforts on patients with low SES will be necessary to improve outcomes of those with HF with reduced ejection fraction.","journal":"UNC Libraries","year":2024,"id":499417,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5846,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1347913,"name":"Anna‐Kucharska Newton","orcid":null,"position":1,"is_corresponding":false},{"id":1076199,"name":"Joseph Coresh","orcid":null,"position":2,"is_corresponding":false},{"id":324779,"name":"Patricia P. Chang","orcid":null,"position":3,"is_corresponding":false},{"id":91402,"name":"Wayne D. Rosamond","orcid":"0000-0001-5271-074X","position":4,"is_corresponding":false},{"id":383569,"name":"Ning Ding","orcid":"0000-0002-3023-8613","position":5,"is_corresponding":false},{"id":762224,"name":"Lena Mathews","orcid":"0000-0003-3780-7572","position":6,"is_corresponding":false},{"id":1292699,"name":"Kensuke Matsushita","orcid":"0000-0002-3722-2921","position":7,"is_corresponding":false},{"id":1346961,"name":"C.E Ndumele","orcid":null,"position":8,"is_corresponding":false},{"id":484667,"name":"Jung‐Im Shin","orcid":"0000-0003-0374-6927","position":9,"is_corresponding":false},{"id":1347914,"name":"Y Mok","orcid":null,"position":10,"is_corresponding":false},{"id":265847,"name":"Deidra C. Crews","orcid":"0000-0003-3425-5776","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:09:53.188165Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}