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Socioeconomic factors and mortality in patients with atrial fibrillation: a cohort study in Swedish primary care
Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Div Family Med & Primary Care, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Coll Med & Vet Med, Edinburgh, Midlothian, Scotland;Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia.
Karolinska Univ Hosp, Funct Area Emergency Med, Stockholm, Sweden;Karolinska Inst, Dept Internal Med, Stockholm, Sweden.
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2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 6, p. 1103-1109Article in journal (Refereed) Published
Abstract [en]

Background: Preventing ischaemic stroke attracts significant focus in atrial fibrillation (OAF) 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 (On=12 283) >= 45 years diagnosed with AF at 75 primary care centres in Sweden 2001-07. Cox regression was used to calculate hazard ratios (OHRs) with 95% confidence intervals (OCIs) 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 (OSD 2.4) of follow-up, 3954 (O32.3%) patients had died; 1971 were women (O35.0%) and 1983 were men (O29.8%). Higher educational level was associated with a reduced mortality in fully adjusted models: HR 0.85 (O95% CI 0.77-0.96) for secondary school in men, HR 0.73 (O95% CI 0.60-0.88) for college/university in women, and HR 0.82 (O95% 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 (O95% CI 1.05-1.50), and HR 1.23 (O95% 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.

Place, publisher, year, edition, pages
2018. Vol. 28, no 6, p. 1103-1109
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Public Health, Global Health, Social Medicine and Epidemiology
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URN: urn:nbn:se:uu:diva-377290DOI: 10.1093/eurpub/cky075ISI: 000456673500023PubMedID: 29746622OAI: oai:DiVA.org:uu-377290DiVA, id: diva2:1289557
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareAvailable from: 2019-02-18 Created: 2019-02-18 Last updated: 2019-02-18Bibliographically approved

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Carlsson, Axel C

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