학술논문
Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation
Document Type
article
Author
Steinberg, Benjamin A; Holmes, DaJuanicia N; Pieper, Karen; Allen, Larry A; Chan, Paul S; Ezekowitz, Michael D; Freeman, James V; Fonarow, Gregg C; Gersh, Bernard J; Hylek, Elaine M; Kowey, Peter R; Mahaffey, Kenneth W; Naccarelli, Gerald; Reiffel, James; Singer, Daniel E; Peterson, Eric D; Piccini, Jonathan P; 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, DP; 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, JS; 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, JE; 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, GL; Labroo, A
Source
Circulation Arrhythmia and Electrophysiology. 13(5)
Subject
Language
Abstract
BackgroundAtrial 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.MethodsWe 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.ResultsOverall, 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