Assessment of the association between quality of life in patients with atrial fibrillation and cardiovascular outcomes during the one-year follow-up

Abstract

Introduction: Research evidence indicates that atrial fibrillation (AF) could have a negative impact on the quality-of-life (QoL). AF symptom pattern and AF-related QoL have been associated with adverse cardiovascular outcomes. Aim: The aims of the present study are to evaluate AF-related impact on QoL using the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire, and to assess the association of QoL with adverse cardiovascular outcomes during the 1-year follow-up. Material and methods: An observational, cohort study that included AF patients treated at the Cardiology Clinic, Clinical Center of Serbia, willing to fill-in AFEQT questionnaire to assess the overall QoL (AFEQT score, 0 to 100) and QoL components: symptoms, daily activities, treatment concerns and treatment satisfaction. During the prospective 1-year follow-up, data on the following outcomes were collected: 1) major adverse cardiovascular outcomes -a combined endpoint, including: stroke/transient ischemic attack, myocardial infarction, percutaneous/surgical coronary revascularization, or cardiovascular death; 2) hospitalization for heart failure. Results: We included 202 AF patients (mean age: 64.5±12.4 years; 62.9% men; 24.3% asymptomatic AF). The mean AFEQT score was 64.3± 8.8. There was a negative correlation between objective estimate of AF-related symptoms and AFEQT score (Spearman rho = -0.489, P<0.001). During 1-year follow-up, major adverse cardiovascular outcomes occurred in 8.4% of patients and 3.5% were hospitalized for heart failure. In a multivariate logistic regression model, controlling for clinical variables, treatment satisfaction score was significantly associated with major adverse cardiovascular outcomes (OR, 0.97; 95%CI, P=0.022), while the overall AFEQT score was associated with heart failure hospitalizations (OR, 0.98; 95%CI, 0.95-0.99; P=0.014). Conclusion: Our results indicate that AF has a negative impact on QoL. Better QoL as assessed by AFEQT score and higher treatment satisfaction are associated with reduced odds for adverse outcomes, which is relevant for clinical risk-stratification and appropriate treatment of AF patients.

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