Socioeconomic factors and mortality in patients with atrial fibrillation-a cohort study in Swedish primary care
(2018) In European Journal of Public Health 28(6). p.1103-1109- Abstract
Background: Preventing ischaemic stroke attracts significant focus in atrial fibrillation (AF) cases. Less is known on the association between socioeconomic factors and mortality and cardiovascular outcomes in patients with AF. Methods: Our study population included adults (n=12 283) ≥45 years diagnosed with AF at 75 primary care centres in Sweden 2001-07. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between the exposures educational level, marital status, neighbourhood socioeconomic status and the outcomes all-cause mortality, after adjustment for age, and comorbid cardiovascular conditions. Results: During a mean of 5.8 years (SD 2.4) of follow-up, 3954 (32.3%)... (More)
Background: Preventing ischaemic stroke attracts significant focus in atrial fibrillation (AF) cases. Less is known on the association between socioeconomic factors and mortality and cardiovascular outcomes in patients with AF. Methods: Our study population included adults (n=12 283) ≥45 years diagnosed with AF at 75 primary care centres in Sweden 2001-07. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between the exposures educational level, marital status, neighbourhood socioeconomic status and the outcomes all-cause mortality, after adjustment for age, and comorbid cardiovascular conditions. Results: During a mean of 5.8 years (SD 2.4) of follow-up, 3954 (32.3%) patients had died; 1971 were women (35.0%) and 1983 were men (29.8%). Higher educational level was associated with a reduced mortality in fully adjusted models: HR 0.85 (95% CI 0.77-0.96) for secondary school in men, HR 0.73 (95% CI 0.60-0.88) for college/university in women, and HR 0.82 (95% CI 0.71-0.94) for college/university in men, compared to primary school. Unmarried men and divorced men had an increased risk of death, compared with married men: HR 1.25 (95% CI 1.05-1.50), and HR 1.23 (95% CI 1.07-1.42), respectively. College/university education level was also associated with lower risk of myocardial infarction in men and women, and lower risk of congestive heart failure in women. Conclusion: More attention could be paid to individuals of lower levels of formal education, and unmarried men, in order to provide timely management for AF and prevent its debilitating complications.
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- author
- Wändell, Per LU ; Carlsson, Axel C. ; Gasevic, Danijela ; Holzmann, Martin J. ; Ärnlöv, Johan ; Sundquist, Jan LU and Sundquist, Kristina LU
- organization
- publishing date
- 2018
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Journal of Public Health
- volume
- 28
- issue
- 6
- pages
- 7 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:29746622
- scopus:85056700296
- ISSN
- 1101-1262
- DOI
- 10.1093/eurpub/cky075
- language
- English
- LU publication?
- yes
- id
- f39752df-d856-4080-a530-4760dd2e5090
- date added to LUP
- 2018-11-27 07:53:02
- date last changed
- 2024-08-21 05:15:29
@article{f39752df-d856-4080-a530-4760dd2e5090, abstract = {{<p>Background: Preventing ischaemic stroke attracts significant focus in atrial fibrillation (AF) cases. Less is known on the association between socioeconomic factors and mortality and cardiovascular outcomes in patients with AF. Methods: Our study population included adults (n=12 283) ≥45 years diagnosed with AF at 75 primary care centres in Sweden 2001-07. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between the exposures educational level, marital status, neighbourhood socioeconomic status and the outcomes all-cause mortality, after adjustment for age, and comorbid cardiovascular conditions. Results: During a mean of 5.8 years (SD 2.4) of follow-up, 3954 (32.3%) patients had died; 1971 were women (35.0%) and 1983 were men (29.8%). Higher educational level was associated with a reduced mortality in fully adjusted models: HR 0.85 (95% CI 0.77-0.96) for secondary school in men, HR 0.73 (95% CI 0.60-0.88) for college/university in women, and HR 0.82 (95% CI 0.71-0.94) for college/university in men, compared to primary school. Unmarried men and divorced men had an increased risk of death, compared with married men: HR 1.25 (95% CI 1.05-1.50), and HR 1.23 (95% CI 1.07-1.42), respectively. College/university education level was also associated with lower risk of myocardial infarction in men and women, and lower risk of congestive heart failure in women. Conclusion: More attention could be paid to individuals of lower levels of formal education, and unmarried men, in order to provide timely management for AF and prevent its debilitating complications.</p>}}, author = {{Wändell, Per and Carlsson, Axel C. and Gasevic, Danijela and Holzmann, Martin J. and Ärnlöv, Johan and Sundquist, Jan and Sundquist, Kristina}}, issn = {{1101-1262}}, language = {{eng}}, number = {{6}}, pages = {{1103--1109}}, publisher = {{Oxford University Press}}, series = {{European Journal of Public Health}}, title = {{Socioeconomic factors and mortality in patients with atrial fibrillation-a cohort study in Swedish primary care}}, url = {{http://dx.doi.org/10.1093/eurpub/cky075}}, doi = {{10.1093/eurpub/cky075}}, volume = {{28}}, year = {{2018}}, }