Evidence map›Paper›PMID 29870433›Full record

ArticleJournal of hypertension2018

Associations between relevant cardiovascular pharmacotherapies and incident heart failure in patients with atrial fibrillation: a cohort study in primary care.

Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Jan Sundquist, Kristina Sundquist

Open access · greenAbstract read
In one paragraph

Article in Journal of hypertension, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 3 countries.

Per WändellDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge.
Axel C CarlssonDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge.
Martin J HolzmannFunctional Area of Emergency Medicine, Karolinska University Hospital.
Johan ÄrnlövDivision of Family Medicine and Primary Care, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge.
Jan SundquistCenter for Primary Health Care Research, Lund University, Malmö, Sweden.
Kristina SundquistCenter for Primary Health Care Research, Lund University, Malmö, Sweden.
Karolinska Institutet · SEIcahn School of Medicine at Mount Sinai · USKarolinska University Hospital · SEShimane University · JP

Funding

Neighborhoods and Coronary Disease: Exploring Mechanisms and Improving MethodsR01HL116381 · NHLBI · LUNDS UNIVERSITET · PI SUNDQUIST, KRISTINA · 2014 to 2017
$1.9M
NHLBI NIH HHS R01 HL116381
6 · The paper itself

Abstract

objectiveTo study association between relevant cardiovascular pharmacotherapy and incident congestive heart failure (CHF) in patients with atrial fibrillation treated in primary health care.

methodsStudy population included all adults (n = 7975) aged 45 years and older diagnosed with atrial fibrillation at 75 primary care centers in Sweden between 2001 and 2007. Outcome was defined as a first diagnosis of CHF post-atrial fibrillation diagnosis. Association between CHF and treatment with relevant cardiovascular pharmacotherapies (beta blockers, calcium blockers, digitalis, diuretics, RAS blockers, and statins) was explored using Cox regression analysis with hazard ratios and 95% CIs. Adjustments were made for age, sociodemographic variables, and comorbid conditions (with or without cardiovascular disorders).

resultsDuring a mean of 5.7 years (SD 2.3) of follow-up, totally 1552 patients (19.5%; 803 women and 749 men) had a recorded CHF diagnosis. Thiazides (hazard ratio 0.74, 95% CI 0.65-0.84), vessel-active calcium channel blockers (hazard ratio 0.76, 95% CI 0.67-0.86), and nonselective beta blockers (hazard ratio 0.84, 95% CI 0.72-0.98), with specifically sotalol representing 80% of nonselective beta blockers (hazard ratio 0.81, 95% CI 0.69-0.97), were associated with lower CHF risk in fully adjusted models. Loop diuretics (hazard ratio 1.41, 95% CI 1.25-1.57) were associated with a higher risk. Findings for thiazides and vessel-active channel blockers were consistent in the tested subgroups.

conclusionIn this clinical setting, we found that thiazides, vessel-active calcium channel blockers, and nonselective beta blockers (specifically sotalol) were associated with a lower risk of incident CHF among patients with atrial fibrillation. The findings of the present study need to be confirmed in other settings.

Indexed as

Primary Health CareAdrenergic beta-AntagonistsAgedAged, 80 and overAtrial FibrillationCalcium Channel BlockersCohort StudiesFemaleHeart FailureHumansMaleMiddle AgedProtective FactorsRisk FactorsSodium Potassium Chloride Symporter InhibitorsSotalolAdrenergic beta-AntagonistsCalcium Channel BlockersSodium Potassium Chloride Symporter InhibitorsSotalolThiazides

Identifiers

PMID29870433
PMCPMC6701474
OpenAlexW2806140515

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.