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Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program.

Publication ,  Journal Article
Steinberg, BA; Zhang, M; Bensch, J; Lyons, A; Bunch, TJ; Piccini, JP; Siu, A; Spertus, JA; Stehlik, J; Wohlfahrt, P; Greene, T; Hess, R; Fang, JC
Published in: J Card Fail
January 2022

BACKGROUND: Atrial fibrillation (AF) frequently complicates heart failure (HF), and each is associated with lower overall health-related quality of life. We aimed to quantify the incremental burden of AF on the health-related quality of life of patients with HF in clinical practice. METHODS AND RESULTS: We used data from the Utah mEVAL program to analyze patient-reported outcomes (PROs) among patients with HF with and without AF. The primary outcome was the HF-specific Kansas City Cardiomyopathy Questionnaire, with generic PROs as secondary outcomes. Among 1707 patients with HF, 36% had AF (n = 616). Those with HF and AF were older (mean age 69 years vs 58 years, P < .001), more likely to have prior stroke (29% vs 17%, P < .001) and ischemic cardiomyopathy (28% vs 23%, P = .01), but had similar ejection fractions (mean 44% each, P = .6). After adjustment, and compared with HF alone, HF with AF was associated with worse Kansas City Cardiomyopathy Questionnaire scores (adjusted mean difference -3.45, 95% confidence interval [CI] -6.24 to -0.65), and worse Patient-Reported Outcomes Measurement Information System physical function scores (adjusted mean difference -1.63, 95% CI -2.59 to -0.67). The difference in visual analog scale general health was borderline (adjusted mean difference -2.01, 95% CI -4.51 to 0.49), and Patient-Reported Outcomes Measurement Information System depression scores were similar (adjusted mean difference 0.54, 95% CI -0.48 to 1.57). CONCLUSIONS: AF complicates nearly one-third of HF cases, and patients with HF and AF are substantially older and sicker. After adjustment, AF was independently associated with worse disease-specific and overall health-related quality of life than HF alone. Whether maintaining sinus rhythm can improve the HF-related health status of patients with HF in clinical practice should be explored further.

Duke Scholars

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Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

January 2022

Volume

28

Issue

1

Start / End Page

13 / 20

Location

United States

Related Subject Headings

  • Valine
  • Utah
  • Stroke Volume
  • Quality of Life
  • Patient Reported Outcome Measures
  • Middle Aged
  • Humans
  • Heart Failure
  • Cardiovascular System & Hematology
  • Atrial Fibrillation
 

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ICMJE
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Steinberg, B. A., Zhang, M., Bensch, J., Lyons, A., Bunch, T. J., Piccini, J. P., … Fang, J. C. (2022). Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program. J Card Fail, 28(1), 13–20. https://doi.org/10.1016/j.cardfail.2021.07.009
Steinberg, Benjamin A., Mingyuan Zhang, Jason Bensch, Ann Lyons, T Jared Bunch, Jonathan P. Piccini, Alfonso Siu, et al. “Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program.J Card Fail 28, no. 1 (January 2022): 13–20. https://doi.org/10.1016/j.cardfail.2021.07.009.
Steinberg BA, Zhang M, Bensch J, Lyons A, Bunch TJ, Piccini JP, et al. Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program. J Card Fail. 2022 Jan;28(1):13–20.
Steinberg, Benjamin A., et al. “Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program.J Card Fail, vol. 28, no. 1, Jan. 2022, pp. 13–20. Pubmed, doi:10.1016/j.cardfail.2021.07.009.
Steinberg BA, Zhang M, Bensch J, Lyons A, Bunch TJ, Piccini JP, Siu A, Spertus JA, Stehlik J, Wohlfahrt P, Greene T, Hess R, Fang JC. Quantifying the Impact of Atrial Fibrillation on Heart Failure-Related Patient-Reported Outcomes in the Utah mEVAL Program. J Card Fail. 2022 Jan;28(1):13–20.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

January 2022

Volume

28

Issue

1

Start / End Page

13 / 20

Location

United States

Related Subject Headings

  • Valine
  • Utah
  • Stroke Volume
  • Quality of Life
  • Patient Reported Outcome Measures
  • Middle Aged
  • Humans
  • Heart Failure
  • Cardiovascular System & Hematology
  • Atrial Fibrillation