Background and purpose The association between annual household income and prognosis of ischaemic stroke remains debatable. We aimed to prospectively investigate the relationship between annual household income and prognosis at 3 months after ischaemic stroke.
Methods We included 3975 participants from the China Antihypertensive Trial in Acute Ischemic Stroke. All participants were categorised into three groups according to annual household income per capita: <¥10 000 (Chinese Yuan Renminbi (RMB)), ¥10 000–19 999 and ≥¥20 000. The primary outcome was a composite outcome of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke onset, and secondary outcomes included major disability, death, and vascular events. A meta-analysis was conducted to incorporate the results of the current study and previous studies on the association of income level with outcomes after stroke.
Results Within 3 months after ischaemic stroke, 1002 participants (25.20%) experienced primary outcome (880 major disabilities and 122 deaths). After multivariate adjustment, low annual household income level was associated with increased risk of the primary outcome (OR 1.60; 95% CI: 1.12 to 2.31; Ptrend=0.034) when two extreme groups were compared. The meta-analysis confirmed the significant association between income level and death or major disability after stroke (pooled relative risk for lowest vs highest income level, 1.31 (95% CI: 1.18 to 1.45)).
Conclusions Low annual household income per capita was significantly associated with increased risks of adverse clinical outcomes at 3 months after ischaemic stroke, independently of established risk factors. Further studies from other samples are needed to replicate our findings due to a reason for excluding some patients who had a severe stroke in this study.
- functioning and disability
- cardiovascular diseases
Data availability statement
Data are available upon reasonable request.
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YZ, ZZ and MS contributed equally.
Contributors TX, JC, YHZ and JH conceived and designed the study. TX and YHZ coordinated the study. ZZ, MS, TX, AW, JC, PY, XX, YP, QL, ZJ, DG, LL, JH and YHZ oversaw subjects’ recruitment and monitored gathering of clinical data. YZ, ZZ and YHZ conducted the statistical analysis and prepared the paper. YHZ and JH revised the paper.
Funding This study was supported by the National Key Research and Development Program of China (grant: 2016YFC1307300), and a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions, China; Tulane University and Collins C Diboll Private Foundation, both in New Orleans, Louisiana, USA.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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