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Mortality in patients with atrial fibrillation and common co-morbidities - a cohort study in primary care
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden.
Karolinska Univ Hosp, Funct Area Emergency Med, Stockholm, Sweden.;Karolinska Inst, Dept Internal Med Solna, Stockholm, Sweden..
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Huddinge, Sweden.;Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden..
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2018 (English)In: Annals of Medicine, ISSN 0785-3890, E-ISSN 1365-2060, Vol. 50, no 2, p. 156-163Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2018. Vol. 50, no 2, p. 156-163
Keywords [en]
Coronary heart disease, cerebrovascular disease, depression, congestive heart failure, gender, hypertension, diabetes
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-347261DOI: 10.1080/07853890.2017.1407036ISI: 000424417900007PubMedID: 29172794OAI: oai:DiVA.org:uu-347261DiVA, id: diva2:1194430
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2018-04-03 Created: 2018-04-03 Last updated: 2018-04-03Bibliographically approved

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