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Abstract
Objectives. To study mortality rates among men and women with atrial fibrillation (AF) and concomitant chronic heart failure (CHF) prescribed different classes of cardiovascular drugs in primary health care. Design. A cohort of men (n = 1159) and women (n = 1155) aged 45 years or above and diagnosed with both AF and CHF from patient records from 75 primary care centers in Sweden were included in the study. Regression models with mortality as the outcome were used, with adjustment for a propensity score comprising age, cardiovascular co-morbidities, education, marital status, and pharmacotherapy. We analysed using Cox regression with hazard ratio (HR), and Laplace regression with years until 10% of the patients had died, with 95% confidence intervals (95% CI). Independent variables were prescribed cardiovascular drugs. Results. Individuals prescribed anticoagulants versus no treatment gained 1.95 years (95% CI 0.47–3.43), anticoagulants versus antiplatelets 1.26 years (95% CI 0.42–2.10), calcium channel blockers 1.17 years (95% CI 0.21–2.14), and statins 1.49 years (95% CI 0.39–2.59). Among patients 80 years or above no significant effect by anticoagulants was seen, HR 0.73 (95% CI 0.43–1.23). Conclusions. Our findings suggest that life may be prolonged in patients with AF and concomitant CHF in primary care prescribed anticoagulants, calcium channel blockers, and statins.
Acknowledgments
This work was supported by ALF funding awarded to Jan Sundquist and Kristina Sundquist and by grants from the Swedish Research Council (awarded to Kristina Sundquist), the Swedish Freemasons Foundation (Jan Sundquist), and the Swedish Council for Working Life and Social Research (Jan Sundquist).
Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.