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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Baseline Health Status and its Association With Subsequent Cardiovascular Events in Patients With Atrial Fibrillation

Nobuhiro Ikemura1, John A Spertus2, Dan D Nguyen2

  • 1Department of Cardiology, Keio University School of Medicine, Tokyo, Japan; University of Missouri's Healthcare Institute for Innovations in Quality and Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.

JACC. Clinical Electrophysiology
|July 27, 2023
PubMed

Insights

Poor health status in atrial fibrillation (AF) patients is common. Lower health status scores are linked to increased risks of major adverse cardiovascular or neurologic events (MACNE).

Area of Science:

  • Cardiology
  • Public Health
  • Patient Outcomes

Background:

  • Optimizing patient health status is a primary goal in atrial fibrillation (AF) clinical practice.
  • The association between disease-specific health status and subsequent clinical events in AF patients remains unclear.

Purpose of the Study:

  • To investigate the relationship between health status and the occurrence of subsequent clinical events in patients diagnosed with AF.
  • To determine if a lower health status score predicts adverse cardiovascular or neurologic events.

Main Methods:

  • A prospective cohort study involving 3,296 new-onset AF patients who completed the Atrial Fibrillation Effects on Quality-of-Life (AFEQT) questionnaire.
  • Analysis of baseline AFEQT Overall Summary (OS) scores and their association with major adverse cardiovascular or neurologic events (MACNE) over a 2-year follow-up period.
  • Statistical adjustments were made for factors associated with baseline AFEQT scores.

Main Results:

  • 15.6% of patients reported poor to fair health status (AFEQT OS <60), and 31.2% reported fair to good health status (AFEQT OS 60 to <80).
  • Lower AFEQT OS scores were associated with female sex, younger age, family history of AF, higher heart rate, paroxysmal AF, emergency department visits, and prior heart failure.
  • A nonlinear increase in MACNE risk was observed for AFEQT OS scores <80, with the strongest association for daily activity scores (HR: 1.65 for <80 vs ≥80).

Conclusions:

  • Diminished health status is prevalent in patients with atrial fibrillation.
  • Lower health status is an independent predictor of subsequent adverse cardiovascular and neurologic events in AF patients.
Abstract

Keywords:
atrial fibrillationquality improvementquality of life

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