Premature Mortality Rates Up for CAD in Women From Rural U.S.
And, rural social determinants of health increase risk for 90-day mortality after heart failure hospitalization
WEDNESDAY, April 22, 2020 (HealthDay News) -- According to the findings of two studies published online April 20 in the Journal of the American Heart Association, coronary artery disease (CAD) mortality rates have increased among women from rural areas, while social determinants of health (SDOH) increase the risk for 90-day mortality after heart failure hospitalization.
Matthias Bossard, M.D., from Kantonsspital Luzerner in Switzerland, and colleagues extracted CAD mortality rates from 1999 to 2017, focusing on mortality from premature CAD (<65 years of age). The researchers observed a decrease in age-adjusted mortality rates for women and men. In rural areas, premature CAD mortality was stagnating among women. A statistically significant increase was seen in CAD mortality rates since 2009 in women aged 55 to 64 years and since 1999 in women aged 45 to 54 years (estimated annual percentage changes [95 percent confidence intervals], +1.4 [+0.3 to +2.5 percent] and +0.6 percent [+0.2 to 1.0 percent], respectively).
Madeline R. Sterling, M.D., M.P.H., from Weill Cornell Medicine in New York City, and colleagues examined age-adjusted associations between each of nine SDOH and 90-day mortality after heart failure hospitalization and created an SDOH count for those associated with 90-day mortality. After adjustment for confounders, the risk for 90-day mortality was determined by the SDOH count. The researchers note that 79 people died within 90 days. The age-adjusted hazard ratio for 90-day mortality was 2.89 and 3.06 for those with one and at least two SDOH, respectively, versus zero SDOH; the corresponding adjusted hazard ratios were 2.78 and 2.57.
"Assessing SDOH may serve as a new marker for identifying and intervening upon the most vulnerable HF patients in the postdischarge period," Sterling and colleagues write.
Several authors from the Sterling study disclosed financial ties to the pharmaceutical industry.