Serial Assessment of Patient-Reported Health Status and Subsequent Clinical Outcomes in Atrial Fibrillation

Area of Science:

• Cardiology
• Health Outcomes Research
• Patient-Reported Outcomes

Background:

• The Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire is standard for assessing quality of life in atrial fibrillation (AF).
• Current practice typically involves single AFEQT measurements, potentially missing dynamic changes in patient health status.
• Serial assessments may offer a more accurate reflection of disease burden over time.

Purpose of the Study:

• To evaluate the association between repeated AFEQT measurements and subsequent clinical outcomes in AF patients.
• To determine if the most recent AFEQT score provides prognostic value compared to baseline scores.

Main Methods:

• Analysis of a prospective multicenter registry of 2,743 stable outpatients with AF in Japan (2012-2018).
• Utilized multivariable Cox models to examine associations of baseline, 12-month, and change in AFEQT overall summary (os) scores with all-cause death and heart failure (HF) hospitalization.
• Employed time-varying analyses to assess the predictive power of updated AFEQT scores.

Main Results:

• Higher recent (12-month) AFEQT-os scores and greater improvements in scores were associated with a lower risk of death or HF hospitalization.
• Baseline AFEQT-os scores did not show significant independent association with outcomes.
• The most recent AFEQT-os score independently predicted mortality and HF hospitalization, even when modeled with change scores.

Conclusions:

• The most recent AFEQT-os score is a significant predictor of mortality and HF hospitalization in AF patients.
• Baseline AFEQT scores offer limited prognostic information compared to updated assessments.
• Regularly updating patient-reported health status via AFEQT can enhance risk assessment in atrial fibrillation management.