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Comparative Study
. 2019 Apr 5;19(1):85.
doi: 10.1186/s12872-019-1059-6.

Association of sex, age and education level with patient reported outcomes in atrial fibrillation

Kelly T Gleason  1 , Cheryl R Dennison Himmelfarb  2 , Daniel E Ford  3 , Harold Lehmann  3 , Laura Samuel  2 , Hae Ra Han  2 , Sandeep K Jain  4 , Gerald V Naccarelli  5 , Vikas Aggarwal  6 , Saman Nazarian  3   7
Affiliations
Comparative Study

Association of sex, age and education level with patient reported outcomes in atrial fibrillation

Kelly T Gleason et al. BMC Cardiovasc Disord. .

Abstract

Background: In atrial fibrillation (AF), there are known sex and sociodemographic disparities in clinical outcomes such as stroke. We investigate whether disparities also exist with respect to patient-reported outcomes. We explored the association of sex, age, and education level with patient-reported outcomes (AF-related quality of life, symptom severity, and emotional and functional status).

Methods: The PaTH AF cohort study recruited participants (N = 953) with an AF diagnosis and age ≥ 18 years across 4 academic medical centers. We performed longitudinal multiple regression with random effects to determine if individual characteristics were associated with patient-reported outcomes.

Results: Women reported poorer functional status (β - 2.23, 95% CI: -3.52, - 0.94) and AF-related quality of life (β - 4.12, 95% CI: -8.10, - 0.14), and higher symptoms of anxiety (β 2.08, 95% CI: 0.76, 3.40), depression (β 1.44, 95% CI: 0.25, 2.63), and AF (β 0.29, 95% CI: 0.08, 0.50). Individuals < 60 years were significantly (p < 0.05) more likely to report higher symptoms of depression, anxiety, and AF, and poorer AF-related quality of life. Lack of college education was associated with reporting higher symptoms of AF (β 0.42, 95% CI: 0.17, 0.68), anxiety (β 1.86, 95% CI: 0.26, 3.45), and depression (β 1.11, 95% CI: 0.15, 2.38), and lower AF-related quality of life (β - 4.41, 95% CI: -8.25, - 0.57) and functional status.

Conclusion: Women, younger adults, and individuals with lower levels of education reported comparatively poor patient-reported outcomes. These findings highlight the importance of understanding why individuals experience AF differently based on certain characteristics.

Keywords: Age; Atrial fibrillation; Longitudinal cohort study; Patient-reported outcomes; Quality of life; Sex; Symptoms.

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Conflict of interest statement

Ethics approval and consent to participate

The PaTH CDRN utilizes a central Institutional Review Board approach which governs the ethics of the entire process. The Johns Hopkins University School of Medicine (FederalWide Assurance 00005752) institutional review board approved this study (JHU IRB00064600). All participants provided electronic or written informed consent to participate, electronic consent was approved by the Johns Hopkins University School of Medicine institutional review board.

Consent for publication

Not applicable, all information is reported in the aggregate.

Competing interests

Dr. Nazarian is a scientific advisor to Biosense Webster, Siemens, Imricor, and CardioSolv Inc. and principal investigator for research funding to the University of Pennsylvania from Biosense Webster, Siemens, and Imricor Inc. Dr. Jain receives research support from Medtronic and is a principal investigator for research funding to the University of Pittsburgh from Medtronic, Boston Scientific, and St. Jude Medical. Dr. Naccarelli receives research support from Janssen and serves as a scientific advisor to Janssen, Glaxo-Smith-Kline, and Daiichi Sankyo. All other authors report no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Violin Plot of Functional Status by Comorbidities and Sex
Fig. 2
Fig. 2
Age and Reported Symptom Severity Over One Year
See this image and copyright information in PMC

References

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