What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation (n=202). Intervention: AFEQT score (overall quality of life). Primary outcome: Hospitalization for heart failure (OR 0.98, 95% CI 0.95-0.99, p=0.014).

What does this research mean for the field?

Higher overall quality of life, as assessed by the AFEQT score, is significantly associated with reduced odds of hospitalization for heart failure in patients with atrial fibrillation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2017Medicinski podmladakOpen Access

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

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Key result

Higher overall quality of life, as assessed by the AFEQT score, was significantly associated with reduced odds of hospitalization for heart failure (OR 0.98) in patients with atrial fibrillation.

Why the study?

Does quality of life assessed by the AFEQT questionnaire predict adverse cardiovascular outcomes in patients with atrial fibrillation?

Study Design

Type

Cohort (n=202)

Multicenter

Structured PICO

Does quality of life assessed by the AFEQT questionnaire predict adverse cardiovascular outcomes in patients with atrial fibrillation?

Population

202 patients with atrial fibrillation (AF) treated at the Cardiology Clinic, Clinical Center of Serbia, mean age 64.5±12.4 years, 62.9% men, 24.3% asymptomatic AF.

Intervention

Quality of life assessment using the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire

Outcome

1) Major adverse cardiovascular outcomes (composite of stroke/transient ischemic attack, myocardial infarction, percutaneous/surgical coronary revascularization, or cardiovascular death); 2) Hospitalization for heart failure at 1-year follow-upcomposite

Main Result

Effect estimate: OR 0.98 (95% CI 0.95-0.99)

p-value: p=0.014

Better quality of life and higher treatment satisfaction assessed by the AFEQT questionnaire are associated with reduced odds of adverse cardiovascular outcomes and heart failure hospitalizations in patients with atrial fibrillation.

Limitations

Relatively small number of participants preventing analysis of individual cardiovascular outcomes and use of Cox proportional hazards regression model
Potential selection bias as inclusion required patients' willingness to independently complete the AFEQT questionnaire

Implication

May aid AF risk stratification; hypothesis-generating and requires prospective validation before practice change.

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, 0.94-0.99, 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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Cite This Study

Vlajković et al. (2017) conducted a cohort in Atrial fibrillation (n=202). AFEQT score (overall quality of life) was evaluated on Hospitalization for heart failure (OR 0.98, 95% CI 0.95-0.99, p=0.014). Higher overall quality of life, as assessed by the AFEQT score, was significantly associated with reduced odds of hospitalization for heart failure (OR 0.98) in patients with atrial fibrillation.

synapsesocial.com/papers/6a14c2c62f0e848eb39ac854 https://doi.org/10.5937/mp68-13857