健康和临床结果的社会决定因素在多变性心肌病的临床结果
Neha Hafeez1, Brian L Claggett2, Anjali T Owens1
1Division of Cardiology, Department of Internal Medicine, University of Pennsylvania, Philadelphia.
JAMA cardiology
|January 7, 2026
概括
健康的社会决定因素,包括收入和贫困,影响了多变性心肌病 (HCM) 的结果. 低收入和高贫困地区与HCM患者心力衰竭和心律失常的风险增加有关.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 遗传学 是一个遗传学.
背景情况:
- 健康的社会决定因素 (SDOH) 影响获得的心脏病风险.
- 对于SDOH对基因驱动的疾病,如缩性心肌病 (HCM) 的影响尚不清楚.
研究的目的:
- 研究基于区域的SDOH与HCM患者的临床结果之间的关联.
- 确定社会经济因素是否影响患有遗传性心脏病的个体的预后.
主要方法:
- 这是一项多中心的前性队列研究,对4431名美国HCM成年患者进行了研究.
- 基于地区的家庭中位数收入和社会贫困指数 (SDI) 估计使用地理编码的住宅地址.
- 多变量模型根据临床因素进行调整,以评估与心力衰竭,心室节律失常和复合结局的关联.
主要成果:
- 较低的家庭收入中位数独立地与心力衰竭风险增加2.07倍和HCM患者复合结局风险增加1.52倍有关.
- 更高的社会贫困指数 (SDI) 独立地与心力衰竭风险增加1.48倍,心室失常风险增加1.55倍,复合结局风险增加1.36倍有关.
- 经过关键临床变量调整后,这些关联仍然显著.
结论:
- 基于地区的社会经济因素,特别是较低的收入和较高的贫困,独立地与患有多变性心肌病的患者的不良临床结果有关.
- 这些发现强调,环境和社会因素在HCM的临床轨迹中发挥着重要作用,即使其基因基础很强.
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