Abstract 809: EQ-5D Utility Index in Atrial Fibrillation: Insights From a Large Multinational Registry of Atrial Fibrillation (Record-AF)
Introduction: Atrial Fibrillation (AF) impairs Health Related Quality of life (HRQoL). No large studies of AF patients have used tools validated for utility index which can be used to compare HRQoL in different disease states and in health economics studies. RECORD-AF is a multinational registry of community patients with recently diagnosed AF (within 1 year). The objective was to evaluate the determinants of the utility index calculated from the frequently used validated generic EQ-5D questionnaire.
Methods and results: The EQ-5D questionnaire was administered to 5604 patients with documented AF. The Atrial Fibrillation Severity Scale (AFSS), a validated scale measuring symptoms related to AF was completed by a subset of 2551 in countries where translations were available. Clinical and demographic characteristics, as well as treatment variables were collected. In order to classify the severity of symptoms of AF, quartiles of the symptom severity score were used (≤ 3, 3–7, 7–14, >14). The Utility Index (range 0 –1.0) was significantly higher (better HRQoL) in subjects treated with a rhythm control strategy (0.79±0.22) compared with a rate control strategy (0.77±0.23, p=0.007). Using multivariate analysis adjusted for confounding factors, symptom severity was the strongest predictor of HRQoL, both in men and women. The variables independently effecting HRQoL are described in the table⇓. Age > 75, presence of CAD, hypertension, diabetes, prior CHF or prior MI, prior stroke, time since diagnosis, and type of AF (paroxysmal vs. persistent) were not predictors of HRQoL.
Conclusion: In a large community based population of AF patients, CHADS2 score, symptom severity score related to AF and gender are the most important determinants of HRQoL.