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Effect of cardiovascular drug classes on all-cause mortality among atrial fibrillation patients treated in primary care in Sweden: a cohort study

Wandell, Per ; Carlsson, Axel C. ; Sundquist, Kristina LU ; Johansson, Sven-Erik LU and Sundquist, Jan LU (2013) In European Journal of Clinical Pharmacology 69(2). p.279-287
Abstract
Risk factors for stroke are well known in atrial fibrillation (AF) patients, while less is known on the effect of these factors on total mortality. Our aim was to study the impact of cardiovascular drug classes on mortality in AF patients treated in primary care. The study population was chosen based on patient data from 75 primary care centres in Sweden compiled in a database. Individuals diagnosed with AF who were older than 45 years were enrolled (n = 12,302, of whom 6,660 were men). Cox regression analysis with mortality (years to death) as outcome was conducted in the men and women separately, as well in the age categories < 80 and a parts per thousand yen80 years, with cardiovascular drugs as independent factors, and age,... (More)
Risk factors for stroke are well known in atrial fibrillation (AF) patients, while less is known on the effect of these factors on total mortality. Our aim was to study the impact of cardiovascular drug classes on mortality in AF patients treated in primary care. The study population was chosen based on patient data from 75 primary care centres in Sweden compiled in a database. Individuals diagnosed with AF who were older than 45 years were enrolled (n = 12,302, of whom 6,660 were men). Cox regression analysis with mortality (years to death) as outcome was conducted in the men and women separately, as well in the age categories < 80 and a parts per thousand yen80 years, with cardiovascular drugs as independent factors, and age, cardiovascular diagnoses and educational level as covariates. Lower mortality was shown for anticoagulant treatment among men, both younger (< 80 years) [adjusted hazard ratio (HR) 0.43, 95 % confidence interval (CI) 0.31-0.61] and older (a parts per thousand yen80 years) (adjusted HR 0.47, 95 % CI 0.32-0.69), and among younger women (adjusted HR 0.46, 95 % CI 0.29-0.74), and for antiplatelet treatment in older men (adjusted HR 0.51, 95 % CI 0.35-0.74). Treatment with thiazides was associated with lower mortality among younger men (adjusted HR 0.68, 95 % CI 0.48-0.96), older men (adjusted HR 0.67, 95 % CI 0.46-0.98) and older women (adjusted HR 0.70, 95 % CI 0.52-0.94). Statins were associated with lower mortality among younger patients, in both men (adjusted HR 0.47, 95 % CI 0.32-0.68) and women (adjusted HR 0.54, 95 % CI 0.35-0.82). The differences in age and gender patterns need further exploration. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antithrombotic drugs, Thiazides, Statins, Pharmacotherapy, Gender, Follow-up
in
European Journal of Clinical Pharmacology
volume
69
issue
2
pages
279 - 287
publisher
Springer
external identifiers
  • wos:000313791600017
  • scopus:84873710133
  • pmid:22990327
ISSN
1432-1041
DOI
10.1007/s00228-012-1395-2
language
English
LU publication?
yes
id
e511a7bd-e2a1-40f1-88fc-6d245ef15faf (old id 3591086)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22990327
date added to LUP
2016-04-01 12:55:15
date last changed
2022-01-27 08:18:14
@article{e511a7bd-e2a1-40f1-88fc-6d245ef15faf,
  abstract     = {{Risk factors for stroke are well known in atrial fibrillation (AF) patients, while less is known on the effect of these factors on total mortality. Our aim was to study the impact of cardiovascular drug classes on mortality in AF patients treated in primary care. The study population was chosen based on patient data from 75 primary care centres in Sweden compiled in a database. Individuals diagnosed with AF who were older than 45 years were enrolled (n = 12,302, of whom 6,660 were men). Cox regression analysis with mortality (years to death) as outcome was conducted in the men and women separately, as well in the age categories &lt; 80 and a parts per thousand yen80 years, with cardiovascular drugs as independent factors, and age, cardiovascular diagnoses and educational level as covariates. Lower mortality was shown for anticoagulant treatment among men, both younger (&lt; 80 years) [adjusted hazard ratio (HR) 0.43, 95 % confidence interval (CI) 0.31-0.61] and older (a parts per thousand yen80 years) (adjusted HR 0.47, 95 % CI 0.32-0.69), and among younger women (adjusted HR 0.46, 95 % CI 0.29-0.74), and for antiplatelet treatment in older men (adjusted HR 0.51, 95 % CI 0.35-0.74). Treatment with thiazides was associated with lower mortality among younger men (adjusted HR 0.68, 95 % CI 0.48-0.96), older men (adjusted HR 0.67, 95 % CI 0.46-0.98) and older women (adjusted HR 0.70, 95 % CI 0.52-0.94). Statins were associated with lower mortality among younger patients, in both men (adjusted HR 0.47, 95 % CI 0.32-0.68) and women (adjusted HR 0.54, 95 % CI 0.35-0.82). The differences in age and gender patterns need further exploration.}},
  author       = {{Wandell, Per and Carlsson, Axel C. and Sundquist, Kristina and Johansson, Sven-Erik and Sundquist, Jan}},
  issn         = {{1432-1041}},
  keywords     = {{Antithrombotic drugs; Thiazides; Statins; Pharmacotherapy; Gender; Follow-up}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{279--287}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Pharmacology}},
  title        = {{Effect of cardiovascular drug classes on all-cause mortality among atrial fibrillation patients treated in primary care in Sweden: a cohort study}},
  url          = {{http://dx.doi.org/10.1007/s00228-012-1395-2}},
  doi          = {{10.1007/s00228-012-1395-2}},
  volume       = {{69}},
  year         = {{2013}},
}