Effects of prescribed antithrombotics and other cardiovascular pharmacotherapies on all-cause mortality in patients with diabetes and atrial fibrillation - a cohort study from Sweden using propensity score analyses
(2014) In Diabetology and Metabolic Syndrome 6.- Abstract
- Aims: To study mortality rates among patients with diabetes and concomitant atrial fibrillation (AF), prescribed different cardiovascular drugs in primary health care. Methods: Study population consisted of men (n = 1319) and women (n = 1094) aged = >= 45 years from a database including 75 primary care centres in Sweden. Cox regression analysis, with hazard ratios (HRs), 95% confidence interval (95% CIs) and mortality (years to death) as outcome, and Laplace regression, with difference in time to first 10% mortality (with 95% CI), were performed. Independent variables were prescribed cardiovascular drugs. Regression models were adjusted for a propensity score calculated separately for each prescribed drug class (comprising age,... (More)
- Aims: To study mortality rates among patients with diabetes and concomitant atrial fibrillation (AF), prescribed different cardiovascular drugs in primary health care. Methods: Study population consisted of men (n = 1319) and women (n = 1094) aged = >= 45 years from a database including 75 primary care centres in Sweden. Cox regression analysis, with hazard ratios (HRs), 95% confidence interval (95% CIs) and mortality (years to death) as outcome, and Laplace regression, with difference in time to first 10% mortality (with 95% CI), were performed. Independent variables were prescribed cardiovascular drugs. Regression models were adjusted for a propensity score calculated separately for each prescribed drug class (comprising age, cardiovascular co-morbidities, education, marital status and pharmacotherapy). Results: Overall mortality was lower in the whole sample for anticoagulants vs no treatment (HR 0.45; 95% CI 0.26-0.77); and among patients < 80 years for anticoagulants vs. antiplatelets (HR 0.44; 95% CI 0.25-0.78); while among individuals aged >= 80 years, antiplatelets (HR 0.47; 95% CI 0.26-0.87) and anticoagulants (HR 0.49; 95% CI 0.24-1.00) vs. no treatment were equally effective. Statins were associated with lower mortality among those < 80 years (HR 0.45; 95% CI 0.29-0.71). Laplace regression models in the whole sample, with years to first 10% of total mortality as outcome, were significant for: among patients < 80 years anticoagulants vs. no treatment 2.70 years (95% CI 0.04-5.37), anticoagulants vs. antiplatelets 2.31 years (95% CI 0.84-3.79), and those >= 80 antiplatelets vs. no treatment 1.78 years (95% CI 1.04-2.52). Conclusions: Our findings suggest that antiplatelets could exert a beneficial effect among those above 80 years. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4319582
- author
- Wandell, Per ; Carlsson, Axel C. ; Sundquist, Jan LU ; Johansson, Sven-Erik LU ; Bottai, Matteo and Sundquist, Kristina LU
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Antithrombotic drugs, Statins, Pharmacotherapy, Mortality, Follow-up
- in
- Diabetology and Metabolic Syndrome
- volume
- 6
- article number
- 2
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000329712300001
- scopus:84892169809
- pmid:24397919
- ISSN
- 1758-5996
- DOI
- 10.1186/1758-5996-6-2
- language
- English
- LU publication?
- yes
- id
- 6d3e755f-2824-4ee2-bc45-20c22ab76941 (old id 4319582)
- date added to LUP
- 2016-04-01 14:26:14
- date last changed
- 2022-03-14 05:53:19
@article{6d3e755f-2824-4ee2-bc45-20c22ab76941,
abstract = {{Aims: To study mortality rates among patients with diabetes and concomitant atrial fibrillation (AF), prescribed different cardiovascular drugs in primary health care. Methods: Study population consisted of men (n = 1319) and women (n = 1094) aged = >= 45 years from a database including 75 primary care centres in Sweden. Cox regression analysis, with hazard ratios (HRs), 95% confidence interval (95% CIs) and mortality (years to death) as outcome, and Laplace regression, with difference in time to first 10% mortality (with 95% CI), were performed. Independent variables were prescribed cardiovascular drugs. Regression models were adjusted for a propensity score calculated separately for each prescribed drug class (comprising age, cardiovascular co-morbidities, education, marital status and pharmacotherapy). Results: Overall mortality was lower in the whole sample for anticoagulants vs no treatment (HR 0.45; 95% CI 0.26-0.77); and among patients < 80 years for anticoagulants vs. antiplatelets (HR 0.44; 95% CI 0.25-0.78); while among individuals aged >= 80 years, antiplatelets (HR 0.47; 95% CI 0.26-0.87) and anticoagulants (HR 0.49; 95% CI 0.24-1.00) vs. no treatment were equally effective. Statins were associated with lower mortality among those < 80 years (HR 0.45; 95% CI 0.29-0.71). Laplace regression models in the whole sample, with years to first 10% of total mortality as outcome, were significant for: among patients < 80 years anticoagulants vs. no treatment 2.70 years (95% CI 0.04-5.37), anticoagulants vs. antiplatelets 2.31 years (95% CI 0.84-3.79), and those >= 80 antiplatelets vs. no treatment 1.78 years (95% CI 1.04-2.52). Conclusions: Our findings suggest that antiplatelets could exert a beneficial effect among those above 80 years.}},
author = {{Wandell, Per and Carlsson, Axel C. and Sundquist, Jan and Johansson, Sven-Erik and Bottai, Matteo and Sundquist, Kristina}},
issn = {{1758-5996}},
keywords = {{Antithrombotic drugs; Statins; Pharmacotherapy; Mortality; Follow-up}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{Diabetology and Metabolic Syndrome}},
title = {{Effects of prescribed antithrombotics and other cardiovascular pharmacotherapies on all-cause mortality in patients with diabetes and atrial fibrillation - a cohort study from Sweden using propensity score analyses}},
url = {{https://lup.lub.lu.se/search/files/3976088/4610927.pdf}},
doi = {{10.1186/1758-5996-6-2}},
volume = {{6}},
year = {{2014}},
}