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Socioeconomic factors and mortality in patients with atrial fibrillation-a cohort study in Swedish primary care
- Source :
- Wändell, P, Carlsson, A C, Gasevic, D, Holzmann, M J, Ärnlöv, J, Sundquist, J & Sundquist, K 2018, ' Socioeconomic factors and mortality in patients with atrial fibrillation – a cohort study in Swedish primary care ', European Journal of Public Health . https://doi.org/10.1093/eurpub/cky075
- Publication Year :
- 2018
- Publisher :
- OXFORD UNIV PRESS, 2018.
-
Abstract
- Background:Preventing ischaemic stroke attracts significant focus in atrial fibrillation (AF) cases. Less is known on the association between socioeconomic factors and mortality and cardiovascular outcomes in patients with AF.Methods:Our study population included adults (n=12 283) ≥45 years diagnosed with AF at 75 primary care centres in Sweden 2001-07. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between the exposures educational level, marital status, neighbourhood socioeconomic status and the outcomes all-cause mortality, after adjustment for age, and comorbid cardiovascular conditions.Results:During a mean of 5.8 years (SD 2.4) of follow-up, 3954 (32.3%) patients had died; 1971 were women (35.0%) and 1983 were men (29.8%). Higher educational level was associated with a reduced mortality in fully adjusted models: HR 0.85 (95% CI 0.77-0.96) for secondary school in men, HR 0.73 (95% CI 0.60-0.88) for college/university in women, and HR 0.82 (95% CI 0.71-0.94) for college/university in men, compared to primary school. Unmarried men and divorced men had an increased risk of death, compared with married men: HR 1.25 (95% CI 1.05-1.50), and HR 1.23 (95% CI 1.07-1.42), respectively. College/university education level was also associated with lower risk of myocardial infarction in men and women, and lower risk of congestive heart failure in women.Conclusion:More attention could be paid to individuals of lower levels of formal education, and unmarried men, in order to provide timely management for AF and prevent its debilitating complications.
- Subjects :
- Male
medicine.medical_specialty
Databases, Factual
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
Atrial Fibrillation
medicine
Single person
Electronic Health Records
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Socioeconomic status
Aged
Proportional Hazards Models
Socioeconomic Determinants
Aged, 80 and over
Sweden
Primary Health Care
Proportional hazards model
business.industry
Public Health, Environmental and Occupational Health
Klinisk medicin
Atrial fibrillation
Middle Aged
medicine.disease
Comorbidity
Social Class
Marital status
Female
Clinical Medicine
business
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 11011262
- Volume :
- 28
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- EUROPEAN JOURNAL OF PUBLIC HEALTH
- Accession number :
- edsair.doi.dedup.....b0a336b3cafbb782cc7e66aee1f21e8d
- Full Text :
- https://doi.org/10.1093/eurpub/cky075