Prospective Assessment of Sex‐Related Differences in Symptom Status and Health Perception Among Patients With Atrial Fibrillation

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Tamara Merkel¹  Stefan Osswald²  Christian Sticherling²  Stefanie Aeschbacher²  Michael Kühne²  David Conen²  Peter Ammann³  Giorgio Moschovitis⁴  Marcello Di Valentino⁵  Dipen Shah⁶  Steffen Blum⁷  Christoph Muff⁷  Andreas Fischer⁷  Paul Erne⁸  Jürg Schläpfer⁹ 

[1] Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland;Division of Cardiology, Department of Medicine, University Hospital Basel, Basel, Switzerland;Division of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland;Division of Cardiology, Ospedale Regionale di Lugano, Ticino, Switzerland;Division of Cardiology, Ospedale San Giovanni Bellinzona, Ticino, Switzerland;Division of Cardiology, University Hospital Geneva, Geneva, Switzerland;Division of Internal Medicine, Department of Medicine, University Hospital Basel, Basel, Switzerland;Lab Signal Transduction, Department of Biomedicine, University of Basel, Switzerland;Service of Cardiology, University Hospital Lausanne, Lausanne, Switzerland;

关键词: atrial fibrillation;    epidemiology;    health perception;    sex‐related differences;    symptoms;   

DOI  :  10.1161/JAHA.116.005401

来源: DOAJ

【 摘 要 】

BackgroundWe prospectively assessed sex‐specific differences in health perception, overall symptom status, and specific symptoms in a large cohort of patients with atrial fibrillation. Methods and ResultsWe performed a prospective multicenter observational cohort study of 1553 patients with atrial fibrillation. Patients completed questionnaires about personal characteristics, comorbidities, and symptoms on a yearly basis. Mean age was 70±11 years among women and 67±12 years among men. Health perception on a visual analogue scale ranging from 0 to 100 (with higher scores indicating better health perception) was significantly lower in women than in men (70 [interquartile range: 50–80] versus 75 [interquartile range: 60–85]; P<0.0001). More women than men had any symptoms (85.0% versus 68.3%; P<0.0001), palpitations (65.2% versus 44.4%; P<0.0001), dizziness (25.6% versus 13.5%; P<0.0001), dyspnea (35.7% versus 21.8%; P<0.0001), and fatigue (25.3% versus 19.1%; P=0.006). At 1‐year follow‐up, symptoms decreased in both sexes but remained more frequent in women (49.1% versus 32.6%, P<0.0001). In multivariable adjusted longitudinal regression models, female sex remained an independent predictor for lower health perception (ß=−4.8; 95% CI, −6.5 to −3.1; P<0.0001), any symptoms (odds ratio [OR]: 2.6; 95% CI, 2.1–3.4; P<0.0001), palpitations (OR: 2.6; 95% CI, 2.1–3.2; P<0.0001), dizziness (OR: 2.9; 95% CI, 2.1–3.9; P<0.0001), dyspnea (OR: 2.1; 95% CI, 1.6–2.8; P<0.0001), fatigue (OR: 1.6; 95% CI, 1.2–2.2; P=0.0008), and chest pain (OR: 1.8; 95% CI, 1.3–2.6; P=0.001). ConclusionsWomen with atrial fibrillation have a substantially higher symptom burden and lower health perception than men. These relationships persisted after multivariable adjustment and during prospective follow‐up.

【 授权许可】

Unknown