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

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.