Open AccessProspective Assessment of Sex‐Related Differences in Symptom Status and Health Perception Among Patients With Atrial Fibrillation
Author(s) -
Blum Steffen,
Muff Christoph,
Aeschbacher Stefanie,
Ammann Peter,
Erne Paul,
Moschovitis Giorgio,
Di Valentino Marcello,
Shah Dipen,
Schläpfer Jürg,
Fischer Andreas,
Merkel Tamara,
Kühne Michael,
Sticherling Christian,
Osswald Stefan,
Conen David
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.005401
Subject(s) - medicine , palpitations , interquartile range , atrial fibrillation , prospective cohort study , odds ratio , cohort , cohort study , cardiology
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.