Máxima Medical Center, Veldhoven, The Netherlands.
Netherlands Heart Network, Michelangelolaan 2, Eindhoven, 5623 EJ, The Netherlands.
Health Qual Life Outcomes. 2023 Apr 5;21(1):33. doi: 10.1186/s12955-023-02112-2.
In this study, the prognostic value of AF-related quality of life (AFEQT) at baseline on Major Adverse Cardiovascular Events (MACE) and improvement of perceived symptoms (EHRA) was assessed. Furthermore, the relationship between QoL and AF-related hospitalizations was assessed.
A cohort of AF-patients diagnosed between November 2014 and October 2019 in four hospitals embedded within the Netherlands Heart Network were prospectively followed for 12 months. MACE was defined as stroke, myocardial infarction, heart failure and/or mortality. Subsequently, MACE, EHRA score improvement and AF-related hospitalizations between baseline and 12 months of follow-up were recorded.
In total, 970 AF-patients were available for analysis. In analyses with patients with complete information on the confounder subset 36/687 (5.2%) AF-patients developed MACE, 190/432 (44.0%) improved in EHRA score and 189/510(37.1%) were hospitalized during 12 months of follow-up. Patients with a low AFEQT score at baseline more often developed MACE (OR(95%CI): 2.42(1.16-5.06)), more often improved in EHRA score (OR(95%CI): 4.55(2.45-8.44) and were more often hospitalized (OR(95%CI): 4.04(2.22-7.01)) during 12 months post diagnosis, compared to patients with a high AFEQT score at baseline.
AF-patients with a lower quality of life at diagnosis more often develop MACE, more often improve on their symptoms and also were more often hospitalized, compared to AF-patients with a higher quality of life. This study highlights that the integration of patient-reported outcomes, such as quality of life, has the potential to be used as a prognostic indicator of the expected disease course for AF.
在这项研究中，评估了基线时与房颤相关的生活质量（AFEQT）对主要心血管不良事件（MACE）和感知症状改善（EHRA）的预后价值。此外，还评估了生活质量与房颤相关住院之间的关系。
在荷兰心脏网络内的四家医院中，对 2014 年 11 月至 2019 年 10 月期间确诊的房颤患者进行前瞻性随访 12 个月。MACE 的定义为中风、心肌梗死、心力衰竭和/或死亡。随后，记录基线和 12 个月随访期间的 MACE、EHRA 评分改善和房颤相关住院情况。
共 970 名房颤患者可进行分析。在对混杂因素子集信息完整的患者进行分析时，36/687（5.2%）名房颤患者发生 MACE，190/432（44.0%）名患者 EHRA 评分改善，189/510（37.1%）名患者在 12 个月随访期间住院。基线时 AFEQT 评分较低的患者发生 MACE 的可能性更高（OR（95%CI）：2.42（1.16-5.06）），EHRA 评分改善的可能性更高（OR（95%CI）：4.55（2.45-8.44）），并且在诊断后 12 个月内住院的可能性更高（OR（95%CI）：4.04（2.22-7.01）），与基线时 AFEQT 评分较高的患者相比。
与生活质量较高的房颤患者相比，诊断时生活质量较低的房颤患者更常发生 MACE，更常改善症状，也更常住院。这项研究强调，整合患者报告的结果，如生活质量，有可能成为房颤预期疾病过程的预后指标。
