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June 6, 2026Circulation JournalOpen Access

Higher AFEQT scores are linked to ~6% lower death or HF hospitalization risk per five-point increase.

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Why the study?

The AFEQT questionnaire is typically measured only once in AF, but serial assessments may better reflect disease burden and prognostic risk over time.

Does serial assessment of AFEQT scores predict all-cause death and heart failure hospitalization in stable outpatients with atrial fibrillation?

Population

2,743 stable outpatients with AF referred to 11 hospitals in Japan

Comparison

Baseline, 12-month, and change in AFEQT overall summary scores

Design

Multicenter prospective registry study

Follow-up

Median 4.0 years

Key result

Higher current AFEQT overall summary scores were associated with a lower risk of death or heart failure hospitalization (HR 0.94; 95% CI 0.91-0.97 per 5-point increase).

Authors

YSYasuyuki ShiraishiRNRyo NakamaruSKShun Kohsaka

Discussion

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Overview

Serial AFEQT assessment may refine prognostication in stable AF outpatients; leaves open whether monitoring improves outcomes or warrants trials.

Key Points

  • To evaluate the association between repeated AFEQT scores and clinical outcomes in patients with atrial fibrillation.
  • Analyzed data from a multicenter, prospective registry of 2,743 stable outpatients with atrial fibrillation
  • Examined associations between baseline and 12-month AFEQT scores with all-cause death and heart failure hospitalization using multivariable Cox models
  • Conducted time-varying analyses to assess the predictive ability of updated AFEQT scores.
  • Higher current AFEQT overall summary scores (per 5-point increase) show lower risk of death/hospitalization (HR 0.94, 95% CI 0.91–0.97)
  • Change in AFEQT scores also associates with lower risk (HR 0.96, 95% CI 0.92–0.99)
  • Only current AFEQT scores independently predict outcomes when modeled together and during time-varying analyses.

Study Design

Type

Cohort (n=2,743)

Multicenter

Yes

Structured PICO

Does serial assessment of AFEQT scores predict all-cause death and heart failure hospitalization in stable outpatients with atrial fibrillation?

P
Population
2,743 stable outpatients with atrial fibrillation in Japan, followed for a median of 4.0 years.
E
Exposure
Serial assessment of Atrial Fibrillation Effect on Quality-of-Life (AFEQT) overall summary scores (specifically 12-month 'current' score and change score)
O
Outcome
Composite of all-cause death and heart failure (HF) hospitalizationcomposite

Main Result

Hazard Ratio: 0.94 (95% CI 0.91–0.97)

Serial assessment of patient-reported health status using the AFEQT questionnaire provides better prognostic value for mortality and heart failure hospitalization in atrial fibrillation patients than a single baseline measurement.

Cite This Study

Shiraishi et al. (2026) conducted a cohort in Atrial fibrillation (n=2,743). Current AFEQT overall summary score vs. Baseline AFEQT overall summary score was evaluated on all-cause death and heart failure (HF) hospitalization (HR 0.94, 95% CI 0.91-0.97). Higher current AFEQT overall summary scores were associated with a lower risk of death or heart failure hospitalization (HR 0.94; 95% CI 0.91-0.97 per 5-point increase).

synapsesocial.com/papers/6a23bfd571a5da9775e77ce8https://doi.org/10.1253/circj.cj-26-0223
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