BACKGROUND: Atrial fibrillation (AF) frequently complicates heart failure (HF), and each is associated with lower overall health-related quality of life. We aimed to quantify the incremental burden of AF on the health-related quality of life of patients with HF in clinical practice. METHODS AND RESULTS: We used data from the Utah mEVAL program to analyze patient-reported outcomes (PROs) among patients with HF with and without AF. The primary outcome was the HF-specific Kansas City Cardiomyopathy Questionnaire, with generic PROs as secondary outcomes. Among 1707 patients with HF, 36% had AF (n = 616). Those with HF and AF were older (mean age 69 years vs 58 years, P < .001), more likely to have prior stroke (29% vs 17%, P < .001) and ischemic cardiomyopathy (28% vs 23%, P = .01), but had similar ejection fractions (mean 44% each, P = .6). After adjustment, and compared with HF alone, HF with AF was associated with worse Kansas City Cardiomyopathy Questionnaire scores (adjusted mean difference -3.45, 95% confidence interval [CI] -6.24 to -0.65), and worse Patient-Reported Outcomes Measurement Information System physical function scores (adjusted mean difference -1.63, 95% CI -2.59 to -0.67). The difference in visual analog scale general health was borderline (adjusted mean difference -2.01, 95% CI -4.51 to 0.49), and Patient-Reported Outcomes Measurement Information System depression scores were similar (adjusted mean difference 0.54, 95% CI -0.48 to 1.57). CONCLUSIONS: AF complicates nearly one-third of HF cases, and patients with HF and AF are substantially older and sicker. After adjustment, AF was independently associated with worse disease-specific and overall health-related quality of life than HF alone. Whether maintaining sinus rhythm can improve the HF-related health status of patients with HF in clinical practice should be explored further.
BACKGROUND: Atrial fibrillation (AF) frequently complicates heart failure (HF), and each is associated with lower overall health-related quality of life. We aimed to quantify the incremental burden of AF on the health-related quality of life of patients with HF in clinical practice. METHODS AND RESULTS: We used data from the Utah mEVAL program to analyze patient-reported outcomes (PROs) among patients with HF with and without AF. The primary outcome was the HF-specific Kansas City Cardiomyopathy Questionnaire, with generic PROs as secondary outcomes. Among 1707 patients with HF, 36% had AF (n = 616). Those with HF and AF were older (mean age 69 years vs 58 years, P < .001), more likely to have prior stroke (29% vs 17%, P < .001) and ischemic cardiomyopathy (28% vs 23%, P = .01), but had similar ejection fractions (mean 44% each, P = .6). After adjustment, and compared with HF alone, HF with AF was associated with worse Kansas City Cardiomyopathy Questionnaire scores (adjusted mean difference -3.45, 95% confidence interval [CI] -6.24 to -0.65), and worse Patient-Reported Outcomes Measurement Information System physical function scores (adjusted mean difference -1.63, 95% CI -2.59 to -0.67). The difference in visual analog scale general health was borderline (adjusted mean difference -2.01, 95% CI -4.51 to 0.49), and Patient-Reported Outcomes Measurement Information System depression scores were similar (adjusted mean difference 0.54, 95% CI -0.48 to 1.57). CONCLUSIONS: AF complicates nearly one-third of HF cases, and patients with HF and AF are substantially older and sicker. After adjustment, AF was independently associated with worse disease-specific and overall health-related quality of life than HF alone. Whether maintaining sinus rhythm can improve the HF-related health status of patients with HF in clinical practice should be explored further.
Authors: Mohit K Turagam; Jalaj Garg; William Whang; Samantha Sartori; Jacob S Koruth; Marc A Miller; Noelle Langan; Aamir Sofi; Anthony Gomes; Subbarao Choudry; Srinivas R Dukkipati; Vivek Y Reddy Journal: Ann Intern Med Date: 2018-12-25 Impact factor: 25.391
Authors: Peter A Noseworthy; Bernard J Gersh; David M Kent; Jonathan P Piccini; Douglas L Packer; Nilay D Shah; Xiaoxi Yao Journal: Eur Heart J Date: 2019-04-21 Impact factor: 29.983
Authors: Daniel B Mark; Kevin J Anstrom; Shubin Sheng; Jonathan P Piccini; Khaula N Baloch; Kristi H Monahan; Melanie R Daniels; Tristram D Bahnson; Jeanne E Poole; Yves Rosenberg; Kerry L Lee; Douglas L Packer Journal: JAMA Date: 2019-04-02 Impact factor: 56.272
Authors: Susan M Joseph; Eric Novak; Suzanne V Arnold; Philip G Jones; Himad Khattak; Anne E Platts; Victor G Dávila-Román; Douglas L Mann; John A Spertus Journal: Circ Heart Fail Date: 2013-10-15 Impact factor: 8.790
Authors: Sana M Al-Khatib; Emelia J Benjamin; Christine M Albert; Alvaro Alonso; Cynthia Chauhan; Peng-Sheng Chen; Anne B Curtis; Patrice Desvigne-Nickens; Jennifer E Ho; Carolyn S P Lam; Mark S Link; Kristen K Patton; Margaret M Redfield; Michiel Rienstra; Yves Rosenberg; Renate Schnabel; John A Spertus; Lynne Warner Stevenson; Mellanie True Hills; Adriaan A Voors; Lawton S Cooper; Alan S Go Journal: Circulation Date: 2020-06-08 Impact factor: 29.690