731 Factors associated With Successful Return to Work following Initial Acute Coronary or Acute Heart Failure Presentations

Abstract

Factors influencing return to remunerated work following an acute cardiac illness are poorly defined. We wished to compare the factors in our cohorts following first presentation of acute coronary syndrome(ACS) and decompensated heart failure(HF). Prospectively identified subjects, aged 18-65years, from a rehabilitation population for ACS and HF during 2018-2019 underwent a survey. Of 78cases meeting inclusion criteria, 44 completed the survey(24 HF, 79% male, mean age 54years; 20 ACS, 90% male, mean age 58years). Socio-economic indexes for Areas(SIEFA) index was the same for HF(944) & ACS(940) groups, which represents 28th and 27th percentile for Australia respectively. Cardiovascular risk factors were similar except hypertension(62.5% v 90%; p=0.04) and hypercholesterolemia(42% v 80%; p=0.01) were more common in ACS. Many subjects did not continue beyond Yr12, (63% HF v 45% ACS; p=0.25). Full-time employment was higher in the ACS population (100% v 71%; p=0.01) and they had taken less time off work leading to the index diagnosis (p=0.02). A majority of ACS cases returned to work at 10months as compared with HF (90% v 33.3%; p=0.02). On linear regression analysis, male gender (p=0.013); a diagnosis of ACS (p=0.0003); baseline employment status (p=0.001) and access to financial benefits (p=0.0001) were associated with successful return to work. Successful return to work for patients with first presentation of ACS of HF could not be reliably predicted. Any patients with HF do not return to work, where recurrent symptoms, individual motivation, social support and access to financial benefits have a complex interplay.