Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Europace. 2024 Jun 3;26(6). doi: 10.1093/europace/euae146.
We examine the effects of symptoms and cardiovascular disease (CVD) events on health-related quality of life (HRQOL) and healthcare costs in a European population with atrial fibrillation (AF).
In the EURObservational Research Programme on AF long-term general registry, AF patients from 250 centres in 27 European countries were enrolled and followed for 2 years. We used fixed effects models to estimate the association of symptoms and CVD events on HRQOL and annual healthcare costs. We found significant decrements in HRQOL in AF patients in whom ST-segment elevation myocardial infarction (STEMI) [-0.075 (95% confidence interval -0.144, -0.006)], angina or non-ST-elevation myocardial infarction (NSTEMI) [-0.037 (-0.071, -0.003)], new-onset/worsening heart failure [-0.064 (-0.088, -0.039)], bleeding events [-0.031 (-0.059, -0.003)], thromboembolic events [-0.071 (-0.115, -0.027)], mild symptoms [0.037 (-0.048, -0.026)], or severe/disabling symptoms [-0.090 (-0.108, -0.072)] occurred during the follow-up. During follow-up, annual healthcare costs were associated with an increase of €11 718 (€8497, €14 939) in patients with STEMI, €5823 (€4757, €6889) in patients with angina/NSTEMI, €3689 (€3219, €4158) in patients with new-onset or worsening heart failure, €3792 (€3315, €4270) in patients with bleeding events, and €3182 (€2483, €3881) in patients with thromboembolic events, compared with AF patients without these events. Healthcare costs were primarily driven by inpatient costs. There were no significant differences in HRQOL or healthcare resource use between EU regions or by sex.
Symptoms and CVD events are associated with a high burden on AF patients and healthcare systems throughout Europe.
我们研究了症状和心血管疾病 (CVD) 事件对欧洲心房颤动 (AF) 患者健康相关生活质量 (HRQOL) 和医疗保健成本的影响。
在 EURObservational Research Programme on AF long-term general registry 中，来自 27 个欧洲国家 250 个中心的 AF 患者被纳入并随访 2 年。我们使用固定效应模型估计症状和 CVD 事件对 HRQOL 和年度医疗保健成本的关联。我们发现 ST 段抬高型心肌梗死 (STEMI) [0.075（95%置信区间 0.144，-0.006）]、心绞痛或非 ST 段抬高型心肌梗死 (NSTEMI) [0.037（0.071，-0.003）]、新发/恶化心力衰竭 [0.064（0.088，-0.039）]、出血事件 [0.031（0.059，-0.003）]、血栓栓塞事件 [0.071（0.115，-0.027）]、轻度症状 [0.037（0.048，-0.026）]或严重/致残症状 [0.090（0.108，-0.072）]在随访期间发生的 AF 患者的 HRQOL 明显下降。在随访期间，STEMI 患者的年度医疗保健费用增加了€11718（€8497，€14939），心绞痛/NSTEMI 患者的年度医疗保健费用增加了€5823（€4757，€6889），新发或恶化心力衰竭患者的年度医疗保健费用增加了€3689（€3219，€4158），出血事件患者的年度医疗保健费用增加了€3792（€3315，€4270），血栓栓塞事件患者的年度医疗保健费用增加了€3182（€2483，€3881），与无这些事件的 AF 患者相比。医疗保健成本主要由住院费用驱动。在 HRQOL 或医疗资源使用方面，欧盟各地区或性别之间没有显著差异。
症状和 CVD 事件对整个欧洲的 AF 患者及其医疗保健系统造成了沉重负担。
