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Depression or anxiety and all-cause mortality in adults with atrial fibrillation - A cohort study in Swedish primary care.

Wändell, Per; Carlsson, Axel C; Gasevic, Danijela; Wahlström, Lars; Sundquist, Jan LU and Sundquist, Kristina LU (2016) In Annals of Medicine 48(1-2). p.59-66
Abstract
Objective Our aim was to study depression and anxiety in atrial fibrillation (AF) patients as risk factors for all-cause mortality in a primary care setting. Methods The study population included adults (n = 12 283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. The association between depression or anxiety and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). Analyses were conducted in men and women, adjusted for age, educational level, marital status, neighborhood socio-economic status (SES), change of neighborhood status and anxiety or depression, respectively, and cardiovascular co-morbidities. As a secondary analysis,... (More)
Objective Our aim was to study depression and anxiety in atrial fibrillation (AF) patients as risk factors for all-cause mortality in a primary care setting. Methods The study population included adults (n = 12 283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. The association between depression or anxiety and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). Analyses were conducted in men and women, adjusted for age, educational level, marital status, neighborhood socio-economic status (SES), change of neighborhood status and anxiety or depression, respectively, and cardiovascular co-morbidities. As a secondary analysis, background factors and their association with depression or anxiety were explored. Results The risk of all-cause mortality was higher among men with depression compared to their counterparts without depression even after full adjustment (HR = 1.28, 95% CI 1.08-1.53). For anxiety among men and anxiety or depression among women with AF, no associations were found. Cerebrovascular disease was more common among depressed AF patients. Conclusions Increased awareness of the higher mortality among men with AF and subsequent depression is called for. We suggest a tight follow-up and treatment of both ailments in clinical practice. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Medicine
volume
48
issue
1-2
pages
59 - 66
publisher
Informa Healthcare
external identifiers
  • pmid:26758363
  • scopus:84958757842
  • wos:000370748400009
ISSN
1365-2060
DOI
10.3109/07853890.2015.1132842
language
English
LU publication?
yes
id
3315ba10-fb40-40b5-b2b6-489ccb1ca7e5 (old id 8592251)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26758363?dopt=Abstract
date added to LUP
2016-02-03 11:26:08
date last changed
2017-01-01 07:35:11
@article{3315ba10-fb40-40b5-b2b6-489ccb1ca7e5,
  abstract     = {Objective Our aim was to study depression and anxiety in atrial fibrillation (AF) patients as risk factors for all-cause mortality in a primary care setting. Methods The study population included adults (n = 12 283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. The association between depression or anxiety and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). Analyses were conducted in men and women, adjusted for age, educational level, marital status, neighborhood socio-economic status (SES), change of neighborhood status and anxiety or depression, respectively, and cardiovascular co-morbidities. As a secondary analysis, background factors and their association with depression or anxiety were explored. Results The risk of all-cause mortality was higher among men with depression compared to their counterparts without depression even after full adjustment (HR = 1.28, 95% CI 1.08-1.53). For anxiety among men and anxiety or depression among women with AF, no associations were found. Cerebrovascular disease was more common among depressed AF patients. Conclusions Increased awareness of the higher mortality among men with AF and subsequent depression is called for. We suggest a tight follow-up and treatment of both ailments in clinical practice.},
  author       = {Wändell, Per and Carlsson, Axel C and Gasevic, Danijela and Wahlström, Lars and Sundquist, Jan and Sundquist, Kristina},
  issn         = {1365-2060},
  language     = {eng},
  number       = {1-2},
  pages        = {59--66},
  publisher    = {Informa Healthcare},
  series       = {Annals of Medicine},
  title        = {Depression or anxiety and all-cause mortality in adults with atrial fibrillation - A cohort study in Swedish primary care.},
  url          = {http://dx.doi.org/10.3109/07853890.2015.1132842},
  volume       = {48},
  year         = {2016},
}