For a study, researchers sought to examine the effect of patients’ socioeconomic status on the risk of bleeding following mechanical aortic valve replacement (AVR).

From 1997 to 2018, all patients aged 18 to 70 years who received mechanical AVR were included in this countrywide population-based cohort research. The health data registries were used to collect data. The exposure was quartiles of disposable family income. The primary outcome was hospitalization due to a bleed.

The absolute risk of bleeding after 20 years of follow-up was 20% (95% CI: 17% -24%) in the lowest income quartile (Q1) and 16% (95% CI: 13% -20%) in the top quartile among 5,974 patients (Q4). The risk of bleeding reduced as income level increased and was considerably lower in patients at income level Q3 (HR: 0.77; 95% CI: 0.60-0.99) and Q4 (HR: 0.68; 95% CI: 0.50-0.92) than in Q1. The risk of death from cerebral hemorrhage was five times greater in the lowest income quartile than in the age- and the gender-matched general population (standardized mortality ratio: 5.0; 95% CI: 3.3-7.4).

They found a robust link between socioeconomic status and the risk of hemorrhage in individuals undergoing mechanical AVR. In addition, the findings pointed to poor anticoagulant treatment in patients with lower socioeconomic status and the necessity for anticoagulation medication optimization measures in patients with mechanical heart valves.

Reference: jacc.org/doi/10.1016/j.jacc.2022.04.030