Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 25;14(1):25386.
doi: 10.1038/s41598-024-74478-2.

The impact of education level on all-cause mortality in patients with atrial fibrillation

Áron Sztaniszláv  1 , Anna Björkenheim  2 , Anders Magnuson  3 , Ing-Liss Bryngelsson  4 , Nils Edvardsson  5 , Dritan Poci  2   5   6   7
Affiliations

The impact of education level on all-cause mortality in patients with atrial fibrillation

Áron Sztaniszláv et al. Sci Rep. .

Abstract

The association of socioeconomic status with cardiovascular morbidity and mortality is well known, but data on the influence of education level on mortality in individuals with atrial fibrillation (AF) are scarce. We investigated education level as a predictor of all-cause mortality in patients diagnosed with AF. This retrospective cohort study used a database created from several Swedish nationwide registries to identify all patients hospitalized with a diagnosis of AF hospitalized from 1995 to 2008. Education level was categorized as primary, secondary, and academic. All-cause mortality risk was estimated in subpopulations defined by the Charlson Comorbidity Index and several comorbidities. A total of 272,182 patients (56% male; mean age 72 ± 10 years) were followed for five years. Cox regression models showed a reduction in all-cause mortality risk with increased education level. Hazard ratios (HR) relative to primary education remained significant after stratification and adjustment for several confounders: secondary education HR = 0.88; 95% CI: 0.86-0.89; P < 0.001; academic education HR = 0.70; 95% CI: 0.67-0.72; P < 0.001. Subpopulation analyses confirmed a significant reduction in relative risk with higher education level. Targeted screening and education programs could be effective in reducing mortality in AF patients with fewer years of formal education.

Keywords: All-cause mortality; Atrial fibrillation; Education level; Socioeconomic status.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan-Meier failure estimates by education level, stratified by sex.
Figure 2
Figure 2
(a) Forest plot of five-year all-cause mortality risk across education levels, stratified by selected cardiovascular comorbidities in females. (b) Forest plot of five-year all-cause mortality risk across education levels, stratified by cancer in females.
Figure 3
Figure 3
(a) Forest plot of five-year all-cause mortality risk across education levels, stratified by selected cardiovascular comorbidities in males. (b) Forest plot of five-year all-cause mortality risk across education levels, stratified by cancer in males.
See this image and copyright information in PMC

References

    1. Rangarajan, S. et al. Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study. Lancet Glob Heal7, e748-60 (2019). - PubMed
    1. Havranek, E. P. et al. Social determinants of risk and outcomes for cardiovascular disease: A scientific statement from the American Heart Association. Circulation132, 873–98 (2015). - PubMed
    1. Shavers, V. L. Measurement of socioeconomic status in health disparities research. J Natl Med Assoc99, 1013–23 (2007). - PMC - PubMed
    1. Goli, N. M. et al. Educational attainment is associated with atrial fibrillation symptom severity. PACE - Pacing Clin Electrophysiol35, 1090–6 (2012). - PubMed
    1. Galobardes, B. et al. Indicators of socioeconomic position (part 1). J Epidemiol Community Health60, 7–12 (2006). - PMC - PubMed

LinkOut - more resources