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Depression or anxiety and all-cause mortality in adults with atrial fibrillation: A cohort study in Swedish primary care
Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Family Med, S-14183 Huddinge, Sweden.;Stockholm Cty Council, Acad Primary Care Ctr, Huddinge, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Family Med, S-14183 Huddinge, Sweden.;Stockholm Cty Council, Acad Primary Care Ctr, Huddinge, Sweden..
Univ Edinburgh, Coll Med & Vet Med, Ctr Populat Hlth Sci, Edinburgh, Midlothian, Scotland..
Karolinska Inst, Ctr Psychiat Res, Stockholm, Sweden..
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2016 (English)In: Annals of Medicine, ISSN 0785-3890, E-ISSN 1365-2060, Vol. 48, no 1-2, 59-66 p.Article in journal (Refereed) Published
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Abstract [en]

Objective Our aim was to study depression and anxiety in atrial fibrillation (AF) patients as risk factors for all-cause mortality in a primary care setting.Methods The study population included adults (n=12283) of 45 years and older diagnosed with AF in 75 primary care centres in Sweden. The association between depression or anxiety and all-cause mortality was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). Analyses were conducted in men and women, adjusted for age, educational level, marital status, neighborhood socio-economic status (SES), change of neighborhood status and anxiety or depression, respectively, and cardiovascular co-morbidities. As a secondary analysis, background factors and their association with depression or anxiety were explored.Results The risk of all-cause mortality was higher among men with depression compared to their counterparts without depression even after full adjustment (HR=1.28, 95% CI 1.08-1.53). For anxiety among men and anxiety or depression among women with AF, no associations were found. Cerebrovascular disease was more common among depressed AF patients.Conclusions Increased awareness of the higher mortality among men with AF and subsequent depression is called for. We suggest a tight follow-up and treatment of both ailments in clinical practice.

Place, publisher, year, edition, pages
2016. Vol. 48, no 1-2, 59-66 p.
Keyword [en]
Anticoagulants, anxiety, atrial fibrillation, co-morbidity, depression, follow-up, gender, mortality
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-282002DOI: 10.3109/07853890.2015.1132842ISI: 000370748400009PubMedID: 26758363OAI: oai:DiVA.org:uu-282002DiVA: diva2:916172
Funder
Swedish Research Council, K2009-70X-15428-05-3Swedish Research Council, K2012-70X-15428-08-3NIH (National Institute of Health), R01HL116381
Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2017-11-30Bibliographically approved

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