Table 2

Clinical Outcomes of the PARADIGM-HF and ATMOSPHERE Trials According to Tertiles of Gini Coefficient

Gini Tertile 1Gini Tertile 2Gini Tertile 3
Least Inequality (n = 5,320)Intermediate Group (n = 6,124)Greatest Inequality (n = 3,772)
Gini coefficient<3333-41>41
Primary composite outcome
 Events1,480 (27.8)1,694 (27.7)1,138 (33.7)
 Event rates per 100 person-yrs (95% CI)10.9 (10.4–11.5)11.7 (11.2–12.3)13.7 (12.9–14.5)
  Unadjusted HR1.00 (reference)1.06 (0.99–1.15)1.56 (1.39–1.76)
  Adjusted HR-11.00 (reference)1.03 (0.95–1.11)1.57 (1.38–1.79)
  Adjusted HR-21.00 (reference)0.99 (0.91–1.08)1.46 (1.25–1.70)
HF Hospitalization
 Events941 (17.7)900 (14.7)611 (16.2)
 Event rates per 100 person-yrs (95% CI)6.9 (6.5–7.4)6.2 (5.8–6.6)7.4 (6.8–8.0)
  Unadjusted HR1.00 (reference)0.83 (0.75–0.92)1.57 (1.36–1.81)
  Adjusted HR-11.00 (reference)0.81 (0.72–0.90)1.52 (1.30–1.77)
  Adjusted HR-21.00 (reference)0.85 (0.76–0.96)1.92 (1.58–2.33)
CV death
 Events881 (16.6)1,143 (18.7)801 (21.2)
 Event rates per 100 person-yrs (95% CI)5.9 (5.6–6.3)7.3 (6.9–7.7)8.9 (8.3–9.5)
  Unadjusted HR1.00 (reference)1.24 (1.13–1.37)1.50 (1.29–1.74)
  Adjusted HR-11.00 (reference)1.21 (1.10–1.33)1.55 (1.32–1.82)
  Adjusted HR-21.00 (reference)1.12 (1.01–1.25)1.35 (1.12–1.62)
All-cause death
 Events1,097 (20.6)1,349 (22.0)938 (24.9)
 Event rates per 100 person-yrs (95% CI)7.4 (7.0–7.8)8.6 (8.2–9.1)10.4 (9.8–11.1)
  Unadjusted HR1.00 (reference)1.20 (1.10–1.30)1.44 (1.25–1.65)
  Adjusted HR-11.00 (reference)1.18 (1.08–1.28)1.48 (1.29–1.71)
  Adjusted HR-21.00 (reference)1.13 (1.02–1.24)1.30 (1.10–1.53)

CI = confidence interval; CV = cardiovascular; other abbreviations as in Table 1.

Values are n (%), median (IQR), or mean ± SD. Events are reported as n (%) and as rate per 100 patient-years (95% CI). Primary outcome was tested for competing risk of all non-CV death; first hospitalization for HF was tested for competing risk of all-cause death; and CV death was tested for competing risk of all non-CV death. All models were adjusted for region and randomized treatment at baseline.

  • Adjusted for age, sex, HR, SBP, BMI, NT-proBNP, eGFR, LVEF, and NYHA functional class.

  • Adjusted for age, sex, HR, SBP, BMI, NT-proBNP, eGFR, LVEF, NYHA functional class, per capita income, education index, hospital bed density, and health worker density.