LaMori Joyce C, Mody Samir H, Gross Hillary J, DiBonaventura Marco daCosta, Patel Aarti, Schein Jeffrey, Nelson Winnie W
Janssen Scientific Affairs, LLC, Raritan, NJ 08869, USA.
Crit Pathw Cardiol. 2012 Mar;11(1):14-9. doi: 10.1097/HPC.0b013e318246fae8.
This retrospective, observational study was conducted to determine overlap of prevalence between atrial fibrillation (AF), an increasingly common condition that primarily affects the elderly population, and dyspepsia, which is also common. Because the overlap of these conditions could interfere with health care including medication selection, the effect on patient outcomes was also evaluated. A demographically representative population of adults in the United States self-administered an Internet-based questionnaire, and responses were evaluated to determine the presence of AF and measures of comorbidity, including CHADS2 score of stroke risk. Health-related quality of life, work productivity and activity impairment, and health care resource utilization were also assessed. The impact of dyspepsia on these patient outcomes was then examined with multiple regressions and generalized linear models. From the sample population, 1297 participants reported being diagnosed with AF, of whom 34% (449/1297) reported diagnosis of dyspepsia. Those with dyspepsia had a higher mean CHADS2 score than those without dyspepsia. Despite this higher risk, significantly fewer AF patients with dyspepsia than those without dyspepsia were taking either prescription medication to treat AF or anticoagulants for stroke prevention. Dyspepsia was associated with significantly lower levels of both mental and physical health-related quality of life. Work and activity impairment and health care resource utilization were also significantly higher among AF patients with dyspepsia than among those without. The burden of dyspepsia in AF patients should be considered during medication selection. Selection of agents associated with lower rates of dyspepsia may lead to greater patient acceptance of and adherence to therapy.
这项回顾性观察研究旨在确定心房颤动(AF,一种主要影响老年人群且日益常见的疾病)与同样常见的消化不良之间患病率的重叠情况。由于这些疾病的重叠可能会干扰包括药物选择在内的医疗保健,因此还评估了其对患者预后的影响。美国一个具有人口统计学代表性的成年人群自行填写了一份基于互联网的问卷,并对回答进行评估以确定房颤的存在以及合并症的指标,包括中风风险的CHADS2评分。还评估了与健康相关的生活质量、工作效率和活动障碍以及医疗资源利用情况。然后通过多元回归和广义线性模型研究消化不良对这些患者预后的影响。在样本人群中,1297名参与者报告被诊断患有房颤,其中34%(449/1297)报告被诊断患有消化不良。患有消化不良的患者的平均CHADS2评分高于未患消化不良的患者。尽管风险较高,但与未患消化不良的房颤患者相比,患有消化不良的房颤患者服用治疗房颤的处方药或预防中风的抗凝剂的人数明显较少。消化不良与精神和身体健康相关生活质量的显著降低有关。患有消化不良的房颤患者的工作和活动障碍以及医疗资源利用也明显高于未患消化不良的患者。在选择药物时应考虑房颤患者中消化不良的负担。选择与较低消化不良发生率相关的药物可能会使患者对治疗的接受度和依从性更高。