The association between relevant co-morbidities and prevalent as well as incident heart failure in patients with atrial fibrillation

Research output: Contribution to journalArticle


Background: Congestive heart failure (CHF) is a serious complication in patients with atrial fibrillation (AF). Objective: To study associations between relevant co-morbidities and CHF in patients with AF. Methods: Study population included all adults (n = 12,283) ≥45 years diagnosed with AF at 75 primary care centers in Sweden 2001-2007. Logistic regression was used to calculate odds ratios with 95% confidence intervals (CIs) for the associations between co-morbidities, and prevalent CHF. In a subsample (n = 9424), (excluding patients with earlier CHF), Cox regression was used to estimate hazard ratios with 95% CIs for the association between co-morbidities, and a first hospital diagnosis of CHF, after adjustment for age and socio-economic factors. Results: During 5.4 years' follow-up (standard deviation 2.5), 2259 patients (24.0%; 1135 men, 21.8%, and 1124 women, 26.7%) were diagnosed with CHF. Patients with hypertension were less likely to have CHF, while a diagnosis of coronary heart disease, valvular heart disease, diabetes, or chronic obstructive pulmonary disease (COPD), was consistently associated with CHF among men and women. CHF was more common among women with depression. The relative fully adjusted risk of incident CHF was increased for the following diseases in men with AF: valvular heart disease, cardiomyopathy, and diabetes; and for the following diseases in women: valvular heart disease, diabetes, obesity, and COPD. The corresponding risk was decreased among women for hypertension. Conclusions: In this clinical setting we found hypertension to be associated with a decreased risk of CHF among women; valvular heart disease and diabetes to be associated with an increased risk of CHF in both sexes; and cardiomyopathy to be associated with an increased risk of CHF among men.


External organisations
  • Karolinska Institutet
  • Uppsala University
  • Dalarna University
  • Icahn School of Medicine at Mount Sinai
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
  • Family Medicine


  • Atrial fibrillation, Congestive heart failure, Gender, Hypertension
Original languageEnglish
Pages (from-to)26-32
JournalJournal of Cardiology
Issue number1
Publication statusPublished - 2018
Publication categoryResearch