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Mortality in patients with atrial fibrillation and common co-morbidities – a cohort study in primary care

Wändell, Per LU ; Carlsson, Axel C.; Holzmann, Martin J.; Ärnlöv, Johan; Sundquist, Jan LU and Sundquist, Kristina LU (2018) In Annals of Medicine 50(2). p.156-163
Abstract

Objective: To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation. Methods: The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45–64, 65–74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities. Results: During a mean of 5.8 years (standard deviation 2.4) of follow-up, 3954 (32%) patients died (1971 (35%) women, and 1983 (30%) men). High HRs... (More)

Objective: To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation. Methods: The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45–64, 65–74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities. Results: During a mean of 5.8 years (standard deviation 2.4) of follow-up, 3954 (32%) patients died (1971 (35%) women, and 1983 (30%) men). High HRs were found for congestive heart disease (CHF) and cerebrovascular diseases for all age-groups among men and women (except for the 45–64 year old women); for coronary heart disease among the oldest men; for diabetes among the 65–74 year old men and the 45–64 year old women. Low HRs were found for hypertension among women ≥75 years of age. Conclusions: In this clinical setting, CHF and cerebrovascular diseases were consistently associated with mortality in all age-groups. The possible protective effect by hypertension among elderly women should be interpreted with caution.KEY MESSAGESWe found congestive heart failure and cerebrovascular diseases to be consistently associated with mortality in both women and men.We found hypertension to be associated with lower mortality risk among women ≥75 years of age, although this finding must be interpreted with caution.Depression was found to be associated with increased mortality risk among men and women aged 65–74 years of age.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cerebrovascular disease, congestive heart failure, Coronary heart disease, depression, diabetes, gender, hypertension
in
Annals of Medicine
volume
50
issue
2
pages
156 - 163
publisher
Informa Healthcare
external identifiers
  • scopus:85035104390
ISSN
0785-3890
DOI
10.1080/07853890.2017.1407036
language
English
LU publication?
yes
id
6c73f060-6825-49be-a727-c9a56ec9ba25
date added to LUP
2017-12-14 13:37:56
date last changed
2018-02-09 12:28:23
@article{6c73f060-6825-49be-a727-c9a56ec9ba25,
  abstract     = {<p>Objective: To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation. Methods: The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45–64, 65–74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities. Results: During a mean of 5.8 years (standard deviation 2.4) of follow-up, 3954 (32%) patients died (1971 (35%) women, and 1983 (30%) men). High HRs were found for congestive heart disease (CHF) and cerebrovascular diseases for all age-groups among men and women (except for the 45–64 year old women); for coronary heart disease among the oldest men; for diabetes among the 65–74 year old men and the 45–64 year old women. Low HRs were found for hypertension among women ≥75 years of age. Conclusions: In this clinical setting, CHF and cerebrovascular diseases were consistently associated with mortality in all age-groups. The possible protective effect by hypertension among elderly women should be interpreted with caution.KEY MESSAGESWe found congestive heart failure and cerebrovascular diseases to be consistently associated with mortality in both women and men.We found hypertension to be associated with lower mortality risk among women ≥75 years of age, although this finding must be interpreted with caution.Depression was found to be associated with increased mortality risk among men and women aged 65–74 years of age.</p>},
  author       = {Wändell, Per and Carlsson, Axel C. and Holzmann, Martin J. and Ärnlöv, Johan and Sundquist, Jan and Sundquist, Kristina},
  issn         = {0785-3890},
  keyword      = {cerebrovascular disease,congestive heart failure,Coronary heart disease,depression,diabetes,gender,hypertension},
  language     = {eng},
  number       = {2},
  pages        = {156--163},
  publisher    = {Informa Healthcare},
  series       = {Annals of Medicine},
  title        = {Mortality in patients with atrial fibrillation and common co-morbidities – a cohort study in primary care},
  url          = {http://dx.doi.org/10.1080/07853890.2017.1407036},
  volume       = {50},
  year         = {2018},
}