Individual-Level Socioeconomic Position and Long-Term Prognosis in Danish Heart-Transplant Recipients

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  • Rikke E. Mols
  • Brian B. Løgstrup
  • István Bakos
  • Erzsébet Horváth-Puhó
  • Bo Christensen
  • Christoffer T. Witt
  • Morten Schmidt
  • Gustafsson, Finn
  • Hans Eiskjær

Socioeconomic deprivation can limit access to healthcare. Important gaps persist in the understanding of how individual indicators of socioeconomic disadvantage may affect clinical outcomes after heart transplantation. We sought to examine the impact of individual-level socioeconomic position (SEP) on prognosis of heart-transplant recipients. A population-based study including all Danish first-time heart-transplant recipients (n = 649) was conducted. Data were linked across complete national health registers. Associations were evaluated between SEP and all-cause mortality and first-time major adverse cardiovascular event (MACE) during follow-up periods. The half-time survival was 15.6 years (20-year period). In total, 330 (51%) of recipients experienced a first-time cardiovascular event and the most frequent was graft failure (42%). Both acute myocardial infarction and cardiac arrest occurred in ≤5 of recipients. Low educational level was associated with increased all-cause mortality 10–20 years post-transplant (adjusted hazard ratio [HR] 1.95, 95% confidence interval [CI] 1.19–3.19). During 1–10 years post-transplant, low educational level (adjusted HR 1.66, 95% CI 1.14–2.43) and low income (adjusted HR 1.81, 95% CI 1.02–3.22) were associated with a first-time MACE. In a country with free access to multidisciplinary team management, low levels of education and income were associated with a poorer prognosis after heart transplantation.

Original languageEnglish
Article number10976
JournalTransplant International
Volume36
Number of pages9
ISSN0934-0874
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
Copyright © 2023 Mols, Løgstrup, Bakos, Horváth-Puhó, Christensen, Witt, Schmidt, Gustafsson and Eiskjær.

    Research areas

  • heart transplantation, individual-level, mortality, prognosis, socioeconomic position

ID: 371562465