Kongebro Emilie Katrine, Kronborg Christian, Haugan Ketil Jørgen, Graff Claus, Højberg Søren, Krieger Derk, Brandes Axel, Køber Lars, Svendsen Jesper Hastrup, Diederichsen Søren Zöga
Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Inge Lehmanns Vej 7, Copenhagen, 2100, Denmark.
Department of Economics, University of Southern Denmark, Campusvej 55, Odense, 5230, Denmark.
Qual Life Res. 2025 Aug 31. doi: 10.1007/s11136-025-04047-1.
To investigate health-related quality of life (HRQoL) after atrial fibrillation (AF) detected by screening compared with conventional AF diagnosis.
We used HRQoL data (EQ-5D-5L) from 6004 persons randomised to AF screening with implantable loop recorder and treatment (n = 1501) or to usual care (n = 4503). Annual assessments yielded individual EQ-5D-5L-index (worst=-0.76 best = 1.00) and EQ-VAS scores (Visual Analogue Scale, 0 = worst, 100 = best). Changes were estimated with linear mixed models from before to after incident AF, stroke, and major bleeding. Interaction analyses assessed differences between the randomisation groups.
During three years of follow-up, 693 of 6004 (12%) participants were diagnosed with AF (Screening: 424 of 1501 (28%), usual care: 269 of 4503 (6.0%)), with 636 alive at year three. For participants developing AF, the EQ-5D-5L index score in the screening group declined from 0.87 before to 0.85 after AF (p < 0.001), and from 0.83 before to 0.79 after AF (p < 0.001) in usual care, with less HRQoL decline in the screening group (p = 0.019). For patients developing stroke and major bleeding, the EQ-5D-5L index scores in the screening group declined from 0.82 to 0.78 (p < 0.001) and 0.82 to 0.76 (p < 0.001) before and after diagnosis, and from 0.84 to 0.76 (p < 0.001) and 0.85 to 0.76 (p < 0.001) in usual care, without differences between the randomisation groups. All EQ-VAS analyses yielded very similar results.
AF detected through screening had little negative impact on HRQoL compared with AF detected by usual care. Stroke and major bleeding were followed by large HRQoL reductions, regardless of randomisation group.
The LOOP study is registered at ClinicalTrials.gov, identifier: NCT02036450.
研究与常规房颤诊断相比，通过筛查检测出房颤后的健康相关生活质量（HRQoL）。
我们使用了6004人的HRQoL数据（EQ-5D-5L），这些人被随机分配至使用植入式循环记录仪进行房颤筛查及治疗组（n = 1501）或常规护理组（n = 4503）。年度评估得出个体EQ-5D-5L指数（最差=-0.76，最佳=1.00）和EQ-VAS评分（视觉模拟量表，0 =最差，100 =最佳）。采用线性混合模型估计房颤、中风和大出血发病前后的变化。交互分析评估随机分组之间的差异。
在三年的随访期间，6004名参与者中有693人（12%）被诊断为房颤（筛查组：1501人中有424人（28%），常规护理组：4503人中有269人（6.0%）），其中636人在第三年存活。对于发生房颤的参与者，筛查组的EQ-5D-5L指数评分从房颤前的0.87降至房颤后的0.85（p < 0.001），常规护理组从房颤前的0.83降至房颤后的0.79（p < 0.001），筛查组的HRQoL下降较少（p = 0.019）。对于发生中风和大出血的患者，筛查组的EQ-5D-5L指数评分在诊断前后分别从0.82降至0.78（p < 0.001）和从0.82降至0.76（p < 0.001），常规护理组分别从0.84降至0.76（p < 0.001）和从0.85降至0.76（p < 0.001），随机分组之间无差异。所有EQ-VAS分析得出非常相似的结果。
与常规护理检测出的房颤相比，通过筛查检测出的房颤对HRQoL的负面影响较小。中风和大出血后HRQoL大幅下降，与随机分组无关。
LOOP研究已在ClinicalTrials.gov注册，标识符：NCT02036450。
