title: Effect of cardiovascular drugs on mortality in atrial fibrillation and chronic heart failure.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Huddinge , Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Wändell
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Johansson
authors.forename: Matteo
authors.initials: M
authors.lastname: Bottai
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000401:mortality*; D015897:Comorbidity; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology
keywords: antithrombotic drugs; follow-up; gender; mortality; pharmacotherapy; propensity score; statins