Mortality in patients with atrial fibrillation and common co-morbidities – a cohort study in primary care

<p><b>Objective:</b> To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation.</p> <p><b>Methods:</b> The study population included all adults (<i>n</i> = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45–64, 65–74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities.</p> <p><b>Results:</b> During a mean of 5.8 years (standard deviation 2.4) of follow-up, 3954 (32%) patients died (1971 (35%) women, and 1983 (30%) men). High HRs were found for congestive heart disease (CHF) and cerebrovascular diseases for all age-groups among men and women (except for the 45–64 year old women); for coronary heart disease among the oldest men; for diabetes among the 65–74 year old men and the 45–64 year old women. Low HRs were found for hypertension among women ≥75 years of age.</p> <p><b>Conclusions:</b> In this clinical setting, CHF and cerebrovascular diseases were consistently associated with mortality in all age-groups. The possible protective effect by hypertension among elderly women should be interpreted with caution.KEY MESSAGES</p><p>We found congestive heart failure and cerebrovascular diseases to be consistently associated with mortality in both women and men.</p><p>We found hypertension to be associated with lower mortality risk among women ≥75 years of age, although this finding must be interpreted with caution.</p><p>Depression was found to be associated with increased mortality risk among men and women aged 65–74 years of age.</p><p></p> <p>We found congestive heart failure and cerebrovascular diseases to be consistently associated with mortality in both women and men.</p> <p>We found hypertension to be associated with lower mortality risk among women ≥75 years of age, although this finding must be interpreted with caution.</p> <p>Depression was found to be associated with increased mortality risk among men and women aged 65–74 years of age.</p>