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Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation: Results From ORBIT-AF.

Publication ,  Journal Article
Steinberg, BA; Holmes, DN; Pieper, K; Allen, LA; Chan, PS; Ezekowitz, MD; Freeman, JV; Fonarow, GC; Gersh, BJ; Hylek, EM; Kowey, PR ...
Published in: Circ Arrhythm Electrophysiol
May 2020

BACKGROUND: Atrial fibrillation (AF) adversely impacts health-related quality of life (hrQoL). While some patients demonstrate improvements in hrQoL, the factors associated with large improvements in hrQoL are not well described. METHODS: We assessed factors associated with a 1-year increase in the Atrial Fibrillation Effect on Quality-of-Life score of 1 SD (≥18 points; 3× clinically important difference), among outpatients in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation I registry. RESULTS: Overall, 28% (181/636) of patients had such a hrQoL improvement. Compared with patients not showing large hrQoL improvement, they were of similar age (median 73 versus 74, P=0.3), equally likely to be female (44% versus 48%, P=0.3), but more likely to have newly diagnosed AF at baseline (18% versus 8%; P=0.0004), prior antiarrhythmic drug use (52% versus 40%, P=0.005), baseline antiarrhythmic drug use (34.8% versus 26.8%, P=0.045), and more likely to undergo AF-related procedures during follow-up (AF ablation: 6.6% versus 2.0%, P=0.003; cardioversion: 12.2% versus 5.9%, P=0.008). In multivariable analysis, a history of alcohol abuse (adjusted OR, 2.41; P=0.01) and increased baseline diastolic blood pressure (adjusted OR, 1.23 per 10-point increase and >65 mm Hg; P=0.04) were associated with large improvements in hrQoL at 1 year, whereas patients with prior stroke/transient ischemic attack, chronic obstructive pulmonary disease, and peripheral arterial disease were less likely to improve (P<0.05 for each). CONCLUSIONS: In this national registry of patients with AF, potentially treatable AF risk factors are associated with large hrQoL improvement, whereas less reversible conditions appeared negatively associated with hrQoL improvement. Understanding which patients are most likely to have large hrQoL improvement may facilitate targeting interventions for high-value care that optimizes patient-reported outcomes in AF. Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01165710.

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Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

May 2020

Volume

13

Issue

5

Start / End Page

e007775

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Registries
  • Recovery of Function
  • Quality of Life
  • Outpatients
  • Male
  • Humans
 

Citation

APA
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Steinberg, B. A., Holmes, D. N., Pieper, K., Allen, L. A., Chan, P. S., Ezekowitz, M. D., … ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) Investigators and Patients, . (2020). Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation: Results From ORBIT-AF. Circ Arrhythm Electrophysiol, 13(5), e007775. https://doi.org/10.1161/CIRCEP.119.007775
Steinberg, Benjamin A., DaJuanicia N. Holmes, Karen Pieper, Larry A. Allen, Paul S. Chan, Michael D. Ezekowitz, James V. Freeman, et al. “Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation: Results From ORBIT-AF.Circ Arrhythm Electrophysiol 13, no. 5 (May 2020): e007775. https://doi.org/10.1161/CIRCEP.119.007775.
Steinberg BA, Holmes DN, Pieper K, Allen LA, Chan PS, Ezekowitz MD, et al. Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation: Results From ORBIT-AF. Circ Arrhythm Electrophysiol. 2020 May;13(5):e007775.
Steinberg, Benjamin A., et al. “Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation: Results From ORBIT-AF.Circ Arrhythm Electrophysiol, vol. 13, no. 5, May 2020, p. e007775. Pubmed, doi:10.1161/CIRCEP.119.007775.
Steinberg BA, Holmes DN, Pieper K, Allen LA, Chan PS, Ezekowitz MD, Freeman JV, Fonarow GC, Gersh BJ, Hylek EM, Kowey PR, Mahaffey KW, Naccarelli G, Reiffel J, Singer DE, Peterson ED, Piccini JP, ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) Investigators and Patients. Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation: Results From ORBIT-AF. Circ Arrhythm Electrophysiol. 2020 May;13(5):e007775.

Published In

Circ Arrhythm Electrophysiol

DOI

EISSN

1941-3084

Publication Date

May 2020

Volume

13

Issue

5

Start / End Page

e007775

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Registries
  • Recovery of Function
  • Quality of Life
  • Outpatients
  • Male
  • Humans