Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation
-
Published:2020-05
Issue:5
Volume:13
Page:
-
ISSN:1941-3149
-
Container-title:Circulation: Arrhythmia and Electrophysiology
-
language:en
-
Short-container-title:Circ: Arrhythmia and Electrophysiology
Author:
Steinberg Benjamin A.1, Holmes DaJuanicia N.2, Pieper Karen2, Allen Larry A.3, Chan Paul S.4, Ezekowitz Michael D.5, Freeman James V.6, Fonarow Gregg C.7ORCID, Gersh Bernard J.8ORCID, Hylek Elaine M.9, Kowey Peter R.10ORCID, Mahaffey Kenneth W.10, Naccarelli Gerald11ORCID, Reiffel James12, Singer Daniel E.13, Peterson Eric D.214, Piccini Jonathan P.215ORCID, Mendelson R., Nahhas A., Neutel J., Padanilam B., Pan D., Poock J., Raffetto J., Greengold R., Roan P., Saba F., Sackett M., Schneider R., Seymour Z., Shanes J., Shoemaker J., Simms V., Smiley N., Smith D., Snipes C., Sotolongo R., Staniloae C., Stoltz S., Suresh D.P., Tak T., Tannenbaum A., Turk S., Vora K., Randhawa P., Zebrack J., Silva E., Riley E., Weinstein D., Vasiliauskas T., Goldbarg S., Hayward D., Yarlagadda C., Laurion D., Osunkoya A., Burns R., Castor T., Spiller D., Luttman C., Anton S., McGarvey J., Guthrie R., Deriso G., Flood R., Fleischer L., Fierstein J.S., Aggarwal R., Jacobs G., Adjei N., Akyea-Djamson A., Alfieri A., Bacon J., Bedwell N., Berger P., Berry J., Bhagwat R., Bloom S., Boccalandro F., Capo J., Kapadia S., Casanova R., Morriss III J.E., Christensen T., Elsen J., Farsad R., Fox D., Frandsen B., Gelernt M., Gill S., Grubb S., Hall C., Harris H., Hotchkiss D., Ip J., Jaffrani N., Jones A., Kazmierski J., Waxman F., Kneller G.L., Labroo A., Jaffe B., Lebenthal M., Lee D., Lillestol M., LeClerc K., Maccaro P., Mayer N., Kozlowski J., Benjamin S., Detweiler R., Igic P., Jackson T., Pappas J., Littlefield R., Frey A., Vranian R., Long W., Grena P., Arouni A., Quinn J., Browne K., Forman S., Ebinger M., Blonder R., Snyder H., Slabic S., Williams D., Stein R., Kirkland S., Cohen K., Walthall W., Davis K., Snoddy B., Alvarado O., Leach C., Rothman S., Sharma A., Olatidoye A., AlMahameed S., Rosenthal S., Sutter G., Reiter W., Thompson T., Thew S., Kobayashi J., Williams M., Kramer J., Latif S.A., Rhee B., Adler A., Ruiz-Serrano D., Stringam S., Wolok K., Focil A., Butman S., Ingersoll H., Borge R., Al-Saghir Y., Coats P., Farris N., Shore K., Schwartz M.B., Gornick C., Eilat P., Quinlan E., Paliwal Y., Mitra R., Jingo A., Aslam A.A., Watson R., Voyce S., Turakhia M., Goytia-Leos D., Lurie M., Mallis G., Atwater B., Strobel J., Murray J., Fisher D., Atieh M., Landes R., Drabick A., Harman E., Ashcraft B., Krista M., Videlefsky A., Rivera Zayas E., Tan A.E.
Affiliation:
1. Division of Cardiovascular Medicine, University of Utah Health Sciences Center, Salt Lake City, (B.A.S.). 2. Duke Clinical Research Institute, Durham, NC (D.N.H., K.P., E.D.P., J.P.P.). 3. Division of Cardiology & Colorado Cardiovascular Outcomes Research Consortium, University of Colorado School of Medicine, Aurora (L.A.A.). 4. Saint Luke’s Mid America Heart Institute & Department of Medicine, University of Missouri-Kansas City, MO (P.S.C.). 5. Thomas Jefferson Medical College, Lankenau Medical Center, Wynnewood, PA (M.D.E.). 6. Yale University School of Medicine, New Haven, CT (J.V.F.). 7. UCLA Division of Cardiology, Los Angeles, CA (G.C.F.). 8. Mayo Clinic, Rochester, MN (B.J.G.). 9. Boston University School of Medicine, MA (E.M.H.). 10. Lankenau Institute for Medical Research, Wynnewood, PA (P.R.K.). 11. Stanford University School of Medicine, Palo Alto, CA (K.W.M.). 12. Penn State University School of Medicine, Hershey, PA (G.N.). 13. Columbia University College of Physicians and Surgeons, NY (J.R.). 14. Harvard Medical School & Massachusetts General Hospital, Boston, MA (D.E.S.). 15. Duke University Medical Center, Durham, NC (E.D.P., J.P.P.).
Abstract
Background:
Atrial fibrillation (AF) adversely impacts health-related quality of life (hrQoL). While some patients demonstrate improvements in hrQoL, the factors associated with large improvements in hrQoL are not well described.
Methods:
We assessed factors associated with a 1-year increase in the Atrial Fibrillation Effect on Quality-of-Life score of 1 SD (≥18 points; 3× clinically important difference), among outpatients in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation I registry.
Results:
Overall, 28% (181/636) of patients had such a hrQoL improvement. Compared with patients not showing large hrQoL improvement, they were of similar age (median 73 versus 74,
P
=0.3), equally likely to be female (44% versus 48%,
P
=0.3), but more likely to have newly diagnosed AF at baseline (18% versus 8%;
P
=0.0004), prior antiarrhythmic drug use (52% versus 40%,
P
=0.005), baseline antiarrhythmic drug use (34.8% versus 26.8%,
P
=0.045), and more likely to undergo AF-related procedures during follow-up (AF ablation: 6.6% versus 2.0%,
P
=0.003; cardioversion: 12.2% versus 5.9%,
P
=0.008). In multivariable analysis, a history of alcohol abuse (adjusted OR, 2.41;
P
=0.01) and increased baseline diastolic blood pressure (adjusted OR, 1.23 per 10-point increase and >65 mm Hg;
P
=0.04) were associated with large improvements in hrQoL at 1 year, whereas patients with prior stroke/transient ischemic attack, chronic obstructive pulmonary disease, and peripheral arterial disease were less likely to improve (
P
<0.05 for each).
Conclusions:
In this national registry of patients with AF, potentially treatable AF risk factors are associated with large hrQoL improvement, whereas less reversible conditions appeared negatively associated with hrQoL improvement. Understanding which patients are most likely to have large hrQoL improvement may facilitate targeting interventions for high-value care that optimizes patient-reported outcomes in AF.
Registration:
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01165710.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献
|
|