Atrial fibrillation, oral anticoagulants and health related quality of life

Abstract

Introduction: Atrial fibrillation (AFib) is a disease that can influence the health related quality of life. Also oral anticoagulants can influence it both because of its therapeutic benefits or complications as well as how the anticoagulant usage influence the person's life style by regular laboratory test necessity or diet restrictions. Aim: Determine and analyze whether there is a statistically significant difference comparing health related quality of life between K vitamin antagonist, warfarin, users, novel anticoagulant (NOAC), rivaroxaban, dabigatran, users and patients, who do not use any kind of oral anticoagulant. Materials and methods: A cross-sectional analytic research was made in Pauls Stradins Clinical university hospital, Center of Cardiology in Riga, Latvia during the time period from October 2016 till June 2017. Persons with high-risk non-valvular atrial fibrillation were offered to participate in this research. If the person agreed, an oral interview with questions about disease anamnesis, demographic data, laboratory test results, echocardiography results, modified SF-36 survey, used oral anticoagulant type was held. Data were precised with the help of the case anamnesis information. For statistical data analysis was used SPSS Statistics database. Results: Altogether 218 patients were enrolled, of which 56.9% were female and 43.1% – male, mean age – 70.4 years, mean CHA2D2-VASc score – 4.4. Warfarin used 37.6%, 33.0% – novel oral anticoagulants, but 29.4% did not use any kind of oral anticoagulant. A statistically significant difference was discovered between the mean ranks in physical functioning sections comparing warfarin (mean rank 95.85) with NOACs (mean rank 124.57); p = 0.012. Also a statistically significant difference was in social functioning comparing warfarin (mean rank 96.16) with NOACs (mean rank 119.08); p = 0.026. Age had low negative correlation (r = −0.23) with physical functioning. Duration of atrial fibrillation diagnosis did not have correlations with the results. Conclusion: NOAC usage correlates with the best health related quality of life scores, gaining a statistically significant difference compared to warfarin users in physical functioning (warfarin – 95.85, NOACs – 124.57; p = 0.012) and social functioning mean ranks (warfarin – 95.16, NOACs – 119.08; p = 0.026). Age had low negative correlation with physical functioning scores.