RATIONALE: Lower socioeconomic status (SES) confers a heightened risk of common cardiovascular and pulmonary diseases and increased mortality. The association of SES with outcomes in patients with pulmonary arterial hypertension (PAH) is less clear. OBJECTIVES: To determine the association between SES and outcomes in patients with PAH. METHODS: We performed a prospective cohort study at a national referral center for patients with PAH in China. Two hundred sixty-two consecutive incident patients aged 18 to 65 years with a diagnosis of idiopathic PAH were recruited between January 2007 and June 2011 and followed up until November 2011. The primary endpoint was all-cause mortality. An SES score for each patient was derived from their educational level, annual household income, occupation, and medical reimbursement rate. MEASUREMENTS AND MAIN RESULTS: Patients with a lower SES had higher unadjusted mortality rates, with 3-year survival estimates of 50.1, 70.8, and 86.0% in increasing tertiles of SES (P for trend < 0.001). After adjustment for clinical features, hemodynamics, and type of PAH treatment, the hazard ratios for death were 2.98 (95% confidence interval, 1.51-5.89) in the lowest tertile of SES and 1.80 (95% confidence interval, 0.89-3.63) in the middle tertile of SES compared with the upper tertile (P for trend = 0.006). CONCLUSIONS: A lower SES is strongly associated with a higher risk of death in idiopathic PAH. This association was independent of clinical characteristics, hemodynamics, and treatment. Addressing the health disparities associated with a lower SES may improve the outcomes of patients with PAH.
RATIONALE: Lower socioeconomic status (SES) confers a heightened risk of common cardiovascular and pulmonary diseases and increased mortality. The association of SES with outcomes in patients with pulmonary arterial hypertension (PAH) is less clear. OBJECTIVES: To determine the association between SES and outcomes in patients with PAH. METHODS: We performed a prospective cohort study at a national referral center for patients with PAH in China. Two hundred sixty-two consecutive incident patients aged 18 to 65 years with a diagnosis of idiopathic PAH were recruited between January 2007 and June 2011 and followed up until November 2011. The primary endpoint was all-cause mortality. An SES score for each patient was derived from their educational level, annual household income, occupation, and medical reimbursement rate. MEASUREMENTS AND MAIN RESULTS:Patients with a lower SES had higher unadjusted mortality rates, with 3-year survival estimates of 50.1, 70.8, and 86.0% in increasing tertiles of SES (P for trend < 0.001). After adjustment for clinical features, hemodynamics, and type of PAH treatment, the hazard ratios for death were 2.98 (95% confidence interval, 1.51-5.89) in the lowest tertile of SES and 1.80 (95% confidence interval, 0.89-3.63) in the middle tertile of SES compared with the upper tertile (P for trend = 0.006). CONCLUSIONS: A lower SES is strongly associated with a higher risk of death in idiopathic PAH. This association was independent of clinical characteristics, hemodynamics, and treatment. Addressing the health disparities associated with a lower SES may improve the outcomes of patients with PAH.
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Authors: Hongyang Pi; Chad M Kosanovich; Adam Handen; Michael Tao; Jacqueline Visina; Gabrielle Vanspeybroeck; Marc A Simon; Michael G Risbano; Aken Desai; Michael A Mathier; Belinda N Rivera-Lebron; Quyen Nguyen; Jennifer Kliner; Mehdi Nouraie; Stephen Y Chan Journal: Chest Date: 2020-02-25 Impact factor: 9.410
Authors: Lea Ann Matura; Corey E Ventetuolo; Harold I Palevsky; David J Lederer; Evelyn M Horn; Stephen C Mathai; Diane Pinder; Christine Archer-Chicko; Emilia Bagiella; Kari E Roberts; Russell P Tracy; Paul M Hassoun; Reda E Girgis; Steven M Kawut Journal: Ann Am Thorac Soc Date: 2015-03
Authors: Neeta Thakur; Melissa Martin; Elizabeth Castellanos; Sam S Oh; Lindsey A Roth; Celeste Eng; Emerita Brigino-Buenaventura; Adam Davis; Kelley Meade; Michael A LeNoir; Harold J Farber; Shannon Thyne; Saunak Sen; Kirsten Bibbins-Domingo; Luisa N Borrell; Esteban G Burchard Journal: J Asthma Date: 2014-05-14 Impact factor: 2.515
Authors: Sankar D Navaneethan; Edgard Wehbe; Gustavo A Heresi; Varun Gaur; Omar A Minai; Susana Arrigain; Joseph V Nally; Jesse D Schold; Mahboob Rahman; Raed A Dweik Journal: Clin J Am Soc Nephrol Date: 2014-02-27 Impact factor: 8.237
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