Lower Socioeconomic Status Increases Risk of Hospitalization, Death With Antiarrhythmic Drugs


Class 1C antiarrhythmic drugs were associated with the lowest rate of adverse outcomes.

Socioeconomic status—including age, race, sex, and income—plays an important role in incidences of hospitalization and death in patients taking some classes of antiarrhythmic drugs, according to a poster presented at the American College of Cardiology 71st Annual Scientific Sessions & Expo (ACC.22).1

Prescription patters for antiarrhythmic drugs vary “drastically” across the United States based on geographic location. Using regional electronic medical record databases, researchers extracted prescription data for adult patients with atrial fibrillation diagnosed between 2010 and 2019.

Time to event analyses were performed for stroke, death, and hospitalization.

Researchers evaluated data from 5031 patients, 30.6% of whom were taking antiarrhythmic drugs. Of these patients, 1426 were prescribed Class 3 antiarrhythmic drugs (amiodarone n=1276), 111 were prescribed Class 1C antiarrhythmic drugs, and 3 were prescribed Class 1A antiarrhythmic drugs.

Investigators noted disparities in antiarrhythmic drug prescriptions based on age group, sex, race, and median income. Those taking antiarrhythmic drugs had a higher incidence of death and hospitalization (P <.05 for each) compared with patients not taking these drugs, although patients prescribed Class 1C drugs and taking dronedarone had a lower incidence of death vs amiodarone.

“Patients with lower socioeconomic status and on Class III [antiarrhythmic drugs] are mostly prescribed amiodarone,” the researchers concluded. “However, amiodarone was associated with [a] higher risk of death compared with dronedarone and Class IC [antiarrhythmic drugs].”


  1. El Hajjar AH, Noujaim C, Mekhael M, et al. Antiarrhythmic drug prescription: Socio-economic disparities affect mortality and hospitalization. Presented at: ACC.22; April 2-4, 2022; Washington, D.C. Abstract 1419-094.
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