Health-related quality of life in nonvalvular atrial fibrillation patients with controlled or uncontrolled anticoagulati
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RESEARCH
Health‑related quality of life in nonvalvular atrial fibrillation patients with controlled or uncontrolled anticoagulation status José Felipe Varona1, José Miguel Seguí‑Ripoll2,3, Cristina Lozano‑Duran4, Luis Miguel Cuadrado‑Gómez4, Juan Bautista Montagud‑Moncho5, Antonio Ramos‑Guerrero6, José Carlos Mirete‑Ferrer7, Esther Donado8 and Javier García‑Alegría9* on behalf of the REQUOL Study Group
Abstract Background: There is a dearth of evidence regarding Health-Related Quality of Life (HRQoL) in nonvalvular atrial fibrillation (NVAF) patients undergoing oral anticoagulation therapy. Our objective was to describe HRQoL in NVAF patients on oral anticoagulation, focusing on uncontrolled patients on vitamin K antagonists (VKAs) versus controlled patients on VKAs or non-vitamin K antagonist oral anticoagulants (NOACs), in a real-world setting. Additionally, we assessed the clinical characteristics of patients with uncontrolled anticoagulation. Methods: An observational, multicentre, and cross-sectional study, enrolling 38 Spanish Hospitals’ Internal Medicine Departments. HRQoL was assessed using the validated Spanish version of the Sawicki questionnaire. High self-per‑ ceived HRQoL was indicated by high scores in the general treatment satisfaction and self-efficacy dimensions, and by low scores in the strained social network, daily hassles and distress dimensions. Results: Five hundred and one patients were included for assessment. Mean scores ± SD were closer to a high per‑ ceived HRQoL in controlled than uncontrolled patients for the five dimensions of the questionnaire: 4.9 ± 1.0 versus 3.6 ± 1.3 for general treatment satisfaction; 4.3 ± 1.0 versus 3.6 ± 1.0 for self-efficacy, 3.1 ± 0.9 versus 3.9 ± 1.1 for strained social network, 2.1 ± 0.8 versus 3.0 ± 1.0 for daily hassles and 1.8 ± 0.9 versus 2.6 ± 1.2 for distress. Conclusions: HRQoL in patients with controlled anticoagulant status treated with NOACs or VKAs was better than in patients with uncontrolled anticoagulant status. This seems to indicate that anticoagulation control status influences perception of HRQoL, highlighting the importance of its evaluation when assessing HRQoL in NVAF patients. Keywords: Nonvalvular atrial fibrillation, Health-related quality of life, Vitamin K antagonists, Non-vitamin K antagonist oral anticoagulants, Anticoagulation control Background Atrial fibrillation (AF) is the most common type of arrhythmia worldwide [1] and is associated with episodes of heart failure, cognitive decline, cardiovascular morbidity, an increased mortality risk and a decreased quality of life (QoL) [2–6]. The most serious common complication *Correspondence: [email protected] 9 Hospital Costa del Sol, A‑7, Km 187, 29603 Marbella, Malaga, Spain Full list of author information is available at the end of the article
of AF are embolic events, including stroke [7], which usually result in severe disability and dependence [8]. The prevalence of AF in the general Spanish population over 40 years of age is high (4.4%), and it ri
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