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Health-related Quality of Life and Healthcare Costs of Symptoms and Cardiovascular Disease Events in Patients with Atrial Fibrillation: a Longitudinal Analysis of 27 Countries from the EURObservational Research Programme on Atrial Fibrillation...

Abstract

Aims: We examine the effects of symptoms and cardiovascular disease (CVD) events on health-related quality of life (HRQOL) and healthcare costs in a European population with atrial fibrillation (AF).

Methods And Results: In the EURObservational Research Programme on AF long-term general registry, AF patients from 250 centres in 27 European countries were enrolled and followed for 2 years. We used fixed effects models to estimate the association of symptoms and CVD events on HRQOL and annual healthcare costs. We found significant decrements in HRQOL in AF patients in whom ST-segment elevation myocardial infarction (STEMI) [-0.075 (95% confidence interval -0.144, -0.006)], angina or non-ST-elevation myocardial infarction (NSTEMI) [-0.037 (-0.071, -0.003)], new-onset/worsening heart failure [-0.064 (-0.088, -0.039)], bleeding events [-0.031 (-0.059, -0.003)], thromboembolic events [-0.071 (-0.115, -0.027)], mild symptoms [0.037 (-0.048, -0.026)], or severe/disabling symptoms [-0.090 (-0.108, -0.072)] occurred during the follow-up. During follow-up, annual healthcare costs were associated with an increase of €11 718 (€8497, €14 939) in patients with STEMI, €5823 (€4757, €6889) in patients with angina/NSTEMI, €3689 (€3219, €4158) in patients with new-onset or worsening heart failure, €3792 (€3315, €4270) in patients with bleeding events, and €3182 (€2483, €3881) in patients with thromboembolic events, compared with AF patients without these events. Healthcare costs were primarily driven by inpatient costs. There were no significant differences in HRQOL or healthcare resource use between EU regions or by sex.

Conclusion: Symptoms and CVD events are associated with a high burden on AF patients and healthcare systems throughout Europe.

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References
1.
Ramos-Goni J, Craig B, Oppe M, Ramallo-Farina Y, Pinto-Prades J, Luo N . Handling Data Quality Issues to Estimate the Spanish EQ-5D-5L Value Set Using a Hybrid Interval Regression Approach. Value Health. 2018; 21(5):596-604. DOI: 10.1016/j.jval.2017.10.023. View

2.
Wynn G, Todd D, Webber M, Bonnett L, McShane J, Kirchhof P . The European Heart Rhythm Association symptom classification for atrial fibrillation: validation and improvement through a simple modification. Europace. 2014; 16(7):965-72. PMC: 4070972. DOI: 10.1093/europace/eut395. View

3.
White I, Royston P, Wood A . Multiple imputation using chained equations: Issues and guidance for practice. Stat Med. 2011; 30(4):377-99. DOI: 10.1002/sim.4067. View

4.
Zoni Berisso M, Landolina M, Ermini G, Parretti D, Zingarini G, Degli Esposti L . The cost of atrial fibrillation in Italy: a five-year analysis of healthcare expenditure in the general population. From the Italian Survey of Atrial Fibrillation Management (ISAF) study. Eur Rev Med Pharmacol Sci. 2017; 21(1):175-183. View

5.
Holstenson E, Ringborg A, Lindgren P, Coste F, Diamand F, Nieuwlaat R . Predictors of costs related to cardiovascular disease among patients with atrial fibrillation in five European countries. Europace. 2010; 13(1):23-30. DOI: 10.1093/europace/euq325. View