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

Steffen Blum, Christoph Muff, Stefanie Aeschbacher, Peter Ammann, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jürg Schläpfer, Andreas Fischer, Tamara Merkel, Michael Kühne, Christian Sticherling, Stefan Osswald & David Conen

abstract

BACKGROUND
We 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 RESULTS
We 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).

CONCLUSIONS
Women 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.
   
citation Blum S, Muff C, Aeschbacher S, Ammann P, Erne P, Moschovitis G, Di Valentino M, Shah D, Schläpfer J, Fischer A, Merkel T, Kühne M, Sticherling C, Osswald S, Conen D. Prospective Assessment of Sex-Related Differences in Symptom Status and Health Perception Among Patients With Atrial Fibrillation. J Am Heart Assoc 2017; 6:.
   
type journal paper/review (English)
date of publishing 30-06-2017
journal title J Am Heart Assoc (6/7)
ISSN electronic 2047-9980
PubMed 28666988
DOI 10.1161/JAHA.116.005401