The unmeasured burden: Contribution of depression and psychological stress to patient-reported outcomes in atrial fibrillation

Gisi, Brittany; Althouse, Andrew D.; Mathier, Abigail S.; Pusateri, Alexandra; Rollman, Bruce L.; LaRosa, Anna; Magnani, Jared W.

doi:10.1016/j.ijcard.2019.12.004

Cited by 18 publications

(13 citation statements)

References 41 publications

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“…Depression has been linked to the development and progression of HF 78 . This risk is increased by 18% to 21%diseases, after controlling for other cardiovascular risk factors 79,80 . In patients with chronic heart failure, a meta-analysis of 27 studies reported a pooled prevalence of depression of 33% in women and 26% in men 81 .…”

Section: Depression and Strokementioning

confidence: 97%

“…Depression has been associated with an almost three-fold increase in the odds of the reoccurrence of AF after successful electric cardioversion 92 . Depression in patients with AF is associated with greater symptom severity, decreased QOL, higher mortality rates, and increased healthcare utilization [93][94][95][96][97] . Depression can also result from recurrent AF episodes or the development of complications such as heart failure or stroke 98 .…”

Section: Depression and Arrhythmiasmentioning

confidence: 99%

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Depression and Cardiovascular Diseases

Agarwal¹

2021

ijmsci

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Cardiovascular diseases (CVD) are the leading cause of global morbidity and mortality. Besides imparting enormous human suffering and enhancing premature mortality, they also inflict huge direct and indirect financial costs on the worldwide society. With the easier availability of affordable therapeutics globally, and the relatively paucity of newer innovations, modifiable risk factors are gaining greater importance in the management of this cardiovascular epidemic. Depression is a modifiable risk factor. It is consistently and strongly associated with a higher risk of CVD incidence and mortality. CVD on the other hand, often induces the development of depression. This paper reviews the effects of depression on cardiovascular diseases.

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Section: Depression and Strokementioning

confidence: 97%

Section: Depression and Arrhythmiasmentioning

confidence: 99%

Depression and Cardiovascular Diseases

Agarwal¹

2021

ijmsci

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“…The prevalence of anxiety and depression was recently found to be approximately 24% and 28% in AF samples 3 and previously been shown to be associated with symptom severity, QOL, and healthcare utilization. 10,11 Depression has also been associated with a stepwise, progressively adverse change in outcomes of individuals with AF, 12 highlighting the need for assessment and intervention among this population. Similarly, when clinical variables and psychological variables were assessed, only psychological function predicted AF symptom burden and QOL.…”

Section: Who Is More Likely To Experience Af Symptoms and Why?mentioning

confidence: 99%

“…13 The long-term management of AF is burdensome, and depression and anxiety are strongly associated with both treatment adherence and the subjective experience of the condition. 12 The ambiguities of AF causes, symptoms, treatment options, and outcomes may contribute to a patient's perception of their condition. Collectively, these studies highlight that there is not likely a "pure AF symptom experience," but rather symptoms are interpreted through a lens affected by a broad set of factors, including comorbidities such as psychological distress.…”

Section: Who Is More Likely To Experience Af Symptoms and Why?mentioning

confidence: 99%

“…Similarly, when clinical variables and psychological variables were assessed, only psychological function predicted AF symptom burden and QOL 13 . The long‐term management of AF is burdensome, and depression and anxiety are strongly associated with both treatment adherence and the subjective experience of the condition 12 . The ambiguities of AF causes, symptoms, treatment options, and outcomes may contribute to a patient's perception of their condition.…”

Section: Who Is More Likely To Experience Af Symptoms and Why?mentioning

confidence: 99%

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Modern atrial fibrillation care: Becoming a pro at using PROs

Sears

Anthony

Naniwadekar

2020

Cardiovasc electrophysiol

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Association of patient-reported outcomes with hospitalization risk in atrial fibrillation

Chen

Tertulien

Althouse

et al. 2021

American Heart Journal Plus: Cardiology Research and Practice

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Background: Patient-reported outcomes in atrial fibrillation (AF) are increasingly used to evaluate treatment efficacy and as endpoints in clinical trials. Few studies have related patient-reported outcomes in AF to clinical events and outcomes. We examined the association between patient-reported outcomes and hospitalization risk in individuals with AF receiving care at a regional healthcare system. Methods and results: We related the AF Effect on QualiTy of Life (AFEQT), a validated measure (range 0–100) with higher scores indicating superior AF-specific patient-reported outcomes, to hospitalization events in a cohort with prevalent AF. We determined incidence rates for hospitalization events (all-cause, cardiac-, or AF-related) across quartiles of AFEQT scores. We used the Andersen-Gill method to account for multiple hospitalization events per individual and compared the risks of hospitalization across AFEQT quartiles in multivariable-adjusted models. In 339 individuals with AF (age 72.3 ± 10.1 years; 43% women) followed for median 2.6 years (range 0–3.4 years), we observed 417 total hospitalization events. We identified increased incidence rates of hospitalization with progressively decreased AFEQT quartile. Relative to those in the highest AFEQT quartile, individuals in the lowest AFEQT quartile had 3-fold greater risk of all-cause hospitalization (95% Confidence Interval [CI] 1.67–6.57, p < 0.001) and 5-fold greater risk of cardiac hospitalization (95% CI 1.66–13.80, p = 0.004). Conclusions: We identified a progressive association between patient-reported outcomes in AF and risk of hospitalization events. Our results underscore the relevance of patient-reported outcomes to clinical adversity and prognosis in AF.

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The unmeasured burden: Contribution of depression and psychological stress to patient-reported outcomes in atrial fibrillation

Cited by 18 publications

References 41 publications

Depression and Cardiovascular Diseases

Depression and Cardiovascular Diseases

Modern atrial fibrillation care: Becoming a pro at using PROs

Association of patient-reported outcomes with hospitalization risk in atrial fibrillation

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