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Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation

Wändell, Per LU ; Carlsson, Axel C. ; Li, Xinjun LU ; Holzmann, Martin J. ; Sundquist, Jan LU and Sundquist, Kristina LU (2020) In Journal of Clinical Hypertension 22(8). p.1396-1405
Abstract

Congestive heart failure (CHF) is the most important cause of death in patients with atrial fibrillation (AF). We aimed to study the association between cardiovascular drugs in AF patients and incident CHF. The study population included all adults (n = 120 756) aged ≥45 years diagnosed with AF in Sweden diagnosed for the period 1998-2006. Outcome was incident congestive heart failure (follow-up 2007-2015) in AF patients. Associations between treatment with cardiovascular pharmacotherapies and CHF were evaluated using Cox regression to estimate hazard ratios (HRs) with 95% CIs, after adjustment for age, sociodemographic variables, and comorbidities. During a mean 5.3 years (SD 3.0) of follow-up, there were 28 257 (23.4%) incident cases... (More)

Congestive heart failure (CHF) is the most important cause of death in patients with atrial fibrillation (AF). We aimed to study the association between cardiovascular drugs in AF patients and incident CHF. The study population included all adults (n = 120 756) aged ≥45 years diagnosed with AF in Sweden diagnosed for the period 1998-2006. Outcome was incident congestive heart failure (follow-up 2007-2015) in AF patients. Associations between treatment with cardiovascular pharmacotherapies and CHF were evaluated using Cox regression to estimate hazard ratios (HRs) with 95% CIs, after adjustment for age, sociodemographic variables, and comorbidities. During a mean 5.3 years (SD 3.0) of follow-up, there were 28 257 (23.4%) incident cases of CHF. Treatment with beta-1-selective and non-selective beta-blockers and statins was associated with lower risks of incident CHF in men, HR, (95% CI); 0.90, (0.87-0.94); 0.90, (0.84-0.97), and 0.94, (0.90-0.99), respectively. Only beta-1-selective beta-blockers were protective in women 0.94 (0.91-0.98). Treatment with loop diuretics, potassium-saving agents, ACE inhibitors, and angiotensin receptor blockers was associated with a higher risk of CHF. For men, treatment with heart-active calcium channel blockers also led to a higher risk of CHF. In conclusion, we found that beta-blockers, in particular, but also statins were associated with lower risk of incident CHF in patients with AF.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atrial fibrillation, congestive heart failure, drug treatment, gender
in
Journal of Clinical Hypertension
volume
22
issue
8
pages
10 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85087896406
  • pmid:32667702
ISSN
1524-6175
DOI
10.1111/jch.13931
language
English
LU publication?
yes
id
0ae7b2e6-4e5e-436e-b002-50aa530cc6ae
date added to LUP
2020-07-30 12:35:56
date last changed
2021-06-08 04:48:58
@article{0ae7b2e6-4e5e-436e-b002-50aa530cc6ae,
  abstract     = {<p>Congestive heart failure (CHF) is the most important cause of death in patients with atrial fibrillation (AF). We aimed to study the association between cardiovascular drugs in AF patients and incident CHF. The study population included all adults (n = 120 756) aged ≥45 years diagnosed with AF in Sweden diagnosed for the period 1998-2006. Outcome was incident congestive heart failure (follow-up 2007-2015) in AF patients. Associations between treatment with cardiovascular pharmacotherapies and CHF were evaluated using Cox regression to estimate hazard ratios (HRs) with 95% CIs, after adjustment for age, sociodemographic variables, and comorbidities. During a mean 5.3 years (SD 3.0) of follow-up, there were 28 257 (23.4%) incident cases of CHF. Treatment with beta-1-selective and non-selective beta-blockers and statins was associated with lower risks of incident CHF in men, HR, (95% CI); 0.90, (0.87-0.94); 0.90, (0.84-0.97), and 0.94, (0.90-0.99), respectively. Only beta-1-selective beta-blockers were protective in women 0.94 (0.91-0.98). Treatment with loop diuretics, potassium-saving agents, ACE inhibitors, and angiotensin receptor blockers was associated with a higher risk of CHF. For men, treatment with heart-active calcium channel blockers also led to a higher risk of CHF. In conclusion, we found that beta-blockers, in particular, but also statins were associated with lower risk of incident CHF in patients with AF.</p>},
  author       = {Wändell, Per and Carlsson, Axel C. and Li, Xinjun and Holzmann, Martin J. and Sundquist, Jan and Sundquist, Kristina},
  issn         = {1524-6175},
  language     = {eng},
  number       = {8},
  pages        = {1396--1405},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Clinical Hypertension},
  title        = {Use of cardiovascular drugs and risk of incident heart failure in patients with atrial fibrillation},
  url          = {http://dx.doi.org/10.1111/jch.13931},
  doi          = {10.1111/jch.13931},
  volume       = {22},
  year         = {2020},
}