All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995–2008: a Swedish nationwide long-term case–control study

• Published in: European heart journal Vol. 34; no. 14; pp. 1061 - 1067
• Main Authors: Andersson, Tommy, Magnuson, Anders, Bryngelsson, Ing-Liss, Frøbert, Ole, Henriksson, Karin M., Edvardsson, Nils, Poçi, Dritan
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 2013
• Series: Editor's choice
• Subjects: Adolescent; Adult; Age; Age Distribution; Aged; Atrial fibrillation; Atrial Fibrillation - complications; Atrial Fibrillation - mortality; Cardiac and Cardiovascular Systems; Cardiology; Cardiology and Cardiovascular Disease; Case-Control Studies; Cause of Death; Child; Child, Preschool; Clinical Medicine; Clinical Research; Female; Gender; Hospitalization - statistics & numerical data; Humans; Infant; Kardiologi; Kardiologi och kardiovaskulära sjukdomar; Klinisk medicin; Long term; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Middle Aged; Mortality; Risk Factors; Sex Distribution; Sweden - epidemiology; Young Adult; Sweden
• ISSN: 0195-668X; 1522-9645; 1522-9645
• DOI: 10.1093/eurheartj/ehs469

To evaluate long-term all-cause risk of mortality in women and men hospitalized for the first time with atrial fibrillation (AF) compared with matched controls. A total of 272 186 patients (44% women) ≤ 85 years at the time of hospitalization with incidental AF 1995-2008 and 544 344 matched controls free of in-hospital diagnosis of AF were identified. Patients were followed via record linkage of the Swedish National Patient Registry and the Cause of Death Registry. Using Cox regression models, the long-term relative all-cause mortality risk, adjusted for concomitant diseases, in women vs. controls was 2.15, 1.72, and 1.44 (P < 0.001) in the age categories ≤ 65, 65-74, and 75-85 years, respectively. The corresponding figures for men were 1.76, 1.36, and 1.24 (P < 0.001). Among concomitant diseases, neoplasm, chronic renal failure, and chronic obstructive pulmonary disease contributed most to the increased all-cause mortality vs. controls. In patients with AF as the primary diagnosis, the relative risk of mortality was 1.63, 1.46, and 1.28 (P < 0.001) in women and 1.45, 1.17, and 1.10 (P < 0.001) in men. Atrial fibrillation was an independent risk factor of all-cause mortality in patients with incident AF. The concomitant diseases that contributed most were found outside the thromboembolic risk scores. The highest relative risk of mortality was seen in women and in the youngest patients compared with controls, and the differences between genders in each age category were statistically significant.