Social drivers in atrial fibrillation occurrence, screening, treatment, and outcomes: systematic-narrative hybrid review.

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
European Heart Journal Supplements Pub Date : 2024-07-31 eCollection Date: 2024-07-01 DOI:10.1093/eurheartjsupp/suae073
Lars Frost, Søren Paaske Johnsen, Emelia J Benjamin, Ludovic Trinquart, Nicklas Vinter
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引用次数: 0

Abstract

The importance of social drivers of health (SDOH) in the occurrence, detection, treatment, and outcome of atrial fibrillation (AF) has attracted increasing attention. Addressing SDOH factors may suggest opportunities to prevent AF and its complications. We aimed to conduct a structured narrative review and summarize current knowledge on the association between race and ethnicity, SDOH, including rural vs. urban habitation, education, income, and neighbourhood, and the risk of AF, its management, and complications. We identified 537 references in PubMed and 473 references in Embase. After removal of duplicates, we screened the abstracts of 975 references, resulting in 113 references that were examined for eligibility. Subsequently, 34 references were excluded leaving 79 references for the review. Evidence of a social gradient in AF incidence and prevelance were conflicting. However, we found substantial evidence indicating social inequities in the detection of AF, access to treatment, and outcomes such as healthcare utilization, bleeding, heart failure, stroke, dementia, work disability, and death. Inequities are reported across various health care systems and constitute a global problem affecting several continents, although data from Africa and South America are lacking. Given the documented social inequities in AF detection, management, and outcomes, there is an urgent need for healthcare systems, policymakers, and society to identify and implement effective interventions that can reduce inequities and improve outcomes in individuals with AF.

心房颤动发生、筛查、治疗和结果的社会驱动因素:系统叙事混合综述。
健康的社会驱动因素(SDOH)在心房颤动(AF)的发生、检测、治疗和预后中的重要性已引起越来越多的关注。解决 SDOH 因素可能为预防心房颤动及其并发症提供机会。我们旨在对种族和民族、SDOH(包括农村与城市居住地、教育、收入和邻里关系)与心房颤动风险、心房颤动管理和并发症之间的关系进行结构化叙述性综述,并总结当前的相关知识。我们在 PubMed 中找到了 537 篇参考文献,在 Embase 中找到了 473 篇参考文献。去除重复内容后,我们对 975 篇参考文献的摘要进行了筛选,最终对 113 篇参考文献进行了资格审查。随后,34 篇参考文献被排除在外,剩下 79 篇参考文献用于综述。心房颤动发病率和患病率的社会梯度证据相互矛盾。但是,我们发现大量证据表明,在发现心房颤动、获得治疗以及医疗保健使用、出血、心力衰竭、中风、痴呆、工作残疾和死亡等结果方面存在社会不平等。据报道,在各种医疗保健系统中都存在不平等现象,并且是一个影响几大洲的全球性问题,尽管缺乏非洲和南美洲的数据。鉴于在心房颤动的检测、管理和预后方面存在有据可查的社会不公平现象,医疗保健系统、政策制定者和社会迫切需要确定并实施有效的干预措施,以减少不公平现象并改善心房颤动患者的预后。
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来源期刊
European Heart Journal Supplements
European Heart Journal Supplements 医学-心血管系统
CiteScore
3.00
自引率
0.00%
发文量
575
审稿时长
12 months
期刊介绍: The European Heart Journal Supplements (EHJs) is a long standing member of the ESC Journal Family that serves as a publication medium for supplemental issues of the flagship European Heart Journal. Traditionally EHJs published a broad range of articles from symposia to special issues on specific topics of interest. The Editor-in-Chief, Professor Roberto Ferrari, together with his team of eminent Associate Editors: Professor Francisco Fernández-Avilés, Professors Jeroen Bax, Michael Böhm, Frank Ruschitzka, and Thomas Lüscher from the European Heart Journal, has implemented a change of focus for the journal. This entirely refreshed version of the European Heart Journal Supplements now bears the subtitle the Heart of the Matter to give recognition to the focus the journal now has. The EHJs – the Heart of the Matter intends to offer a dedicated, scientific space for the ESC, Institutions, National and Affiliate Societies, Associations, Working Groups and Councils to disseminate their important successes globally.
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