Pharmacotherapy and mortality in atrial fibrillation—a cohort of men and women 75 years or older in Sweden.

Background: atrial fibrillation (AF) is a common cardiovascular morbidity, not least among elderly people, and is treated with different classes of cardiovascular pharmacotherapies.Hypothesis: cardiovascular drugs may have a different impact on survival in elderly patients with AF in primary health...

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Published in:Age & Ageing Vol. 44; no. 2; pp. 232 - 239
Main Authors: Wändell, Per Erik, Carlsson, Axel Carl, Sundquist, Jan, Johansson, Sven-Erik, Bottai, Matteo, Sundquist, Kristina
Format: Article
Published: Oxford University Press / USA Mar2015
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Mar2015
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      pub: Oxford University Press / USA
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        10.1093/ageing/afu153
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        atl: Pharmacotherapy and mortality in atrial fibrillation—a cohort of men and women 75 years or older in Sweden.
      aug:
        au:
          Wändell, Per Erik
          Carlsson, Axel Carl
          Sundquist, Jan
          Johansson, Sven-Erik
          Bottai, Matteo
          Sundquist, Kristina
        affil:
          Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge , Sweden
          Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala , Sweden
          Center for Primary Health Care Research , Lund University , Malmö , Sweden
          Stanford Prevention Research Center , Stanford University School of Medicine , CA , USA
          Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm , Sweden
      su:
        Sweden
        Mortality
        Therapeutics
        Therapeutic use of fibrinolytic agents
        Cardiovascular agents
        Atrial fibrillation
        Chi-squared test
        Confidence intervals
        Fisher exact test
        Regression analysis
        Research funding
        Survival
        T-test (Statistics)
        Proportional hazards models
        Data analysis software
        Descriptive statistics
        Disease complications
      sug:
        subj:
          Mortality
          Therapeutics
          Sweden
          Therapeutic use of fibrinolytic agents
          Cardiovascular agents
          Atrial fibrillation
          Chi-squared test
          Confidence intervals
          Fisher exact test
          Regression analysis
          Research funding
          Survival
          T-test (Statistics)
          Proportional hazards models
          Data analysis software
          Descriptive statistics
          Disease complications
      keyword:
        antithrombotic drugs
        mortality
        older people
        propensity score
        statins
        antithrombotic drugs
        mortality
        older people
        propensity score
        statins
      ab: Background: atrial fibrillation (AF) is a common cardiovascular morbidity, not least among elderly people, and is treated with different classes of cardiovascular pharmacotherapies.Hypothesis: cardiovascular drugs may have a different impact on survival in elderly patients with AF in primary health care.Methods: a cohort of 3,020 men and 3,749 women aged ≥75 and diagnosed with AF were selected from 75 primary care centres in Sweden. Laplace regression was used with years to death of the first 10% of the participants as the outcome. Independent variables were prescribed cardiovascular drugs. Regression models were adjusted for a propensity score comprising age, cardiovascular co-morbidities, socio-economic factors and other cardiovascular pharmacotherapies.Results: overall, mortality was 18.2%. The main finding of this study was survival increases associated with anticoagulants versus no treatment and versus antiplatelets of 1.95 years (95% confidence interval (CI) 1.43–2.48) and 0.78 years (95% CI 0.38–1.18), respectively, and survival increases associated with thiazides and calcium channel blockers of 0.81 years (95% CI 0.43–1.18) and 0.83 years (95% CI 0.47–1.18), respectively, in men and women together (results from sex-adjusted models).Conclusion: our findings suggest that anticoagulants, thiazides and calcium channel blockers may lead to longer survival in elderly patients with AF.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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