1. Pharmacotherapy and mortality in atrial fibrillation--a cohort of men and women 75 years or older in Sweden.
- Author
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Wändell PE, Carlsson AC, Sundquist J, Johansson SE, Bottai M, and Sundquist K
- Subjects
- Age Factors, Aged, Aged, 80 and over, Anti-Arrhythmia Agents therapeutic use, Anticoagulants therapeutic use, Atrial Fibrillation diagnosis, Calcium Channel Blockers therapeutic use, Cardiovascular Agents therapeutic use, Chi-Square Distribution, Comorbidity, Diuretics therapeutic use, Female, Geriatric Assessment, Humans, Male, Propensity Score, Regression Analysis, Risk Assessment, Risk Factors, Sex Factors, Socioeconomic Factors, Stroke diagnosis, Sweden, Time Factors, Treatment Outcome, Atrial Fibrillation drug therapy, Atrial Fibrillation mortality, Stroke mortality, Stroke prevention & control
- Abstract
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., (© The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2015
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