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We observed an inverse association between income and heart failure and myocardial infarction (MI) with evidence of progressive risk across decreased income categories. Individuals with household income less then $40 000 had the greatest risk for heart failure (HR 1.17; 95% CI 1.05 to 1.3 and MI (HR 1.18; 95% CI 0.98 to 1.41) compared with those with income ≥$100 000. CONCLUSIONS We identified an association between lower household income and adverse outcomes in a large cohort of individuals with AF. Our findings support consideration