Generalized anxiety is a predictor of impaired quality of life in patients with atrial fibrillation: findings from the prospective observational ARENA study

Objective - Atrial fibrillation (AF) is associated with impaired health-related quality of life (HRQoL), an increased risk of morbidity, and mortality. Traditional AF-related outcomes (e.g., AF recurrence) primarily demonstrate the physiological benefits of AF management but do not focus on the bene...

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Main Authors: Sadlonova, Monika (Author) , Salzmann, Stefan (Author) , Senges, Jochen (Author) , Celano, Christopher M. (Author) , Huffman, Jeff C. (Author) , Borggrefe, Martin (Author) , Akın, Ibrahim (Author) , Thomas, Dierk (Author) , Schwarzbach, Christopher Jan (Author) , Kleemann, Thomas (Author) , Schneider, Steffen (Author) , Hochadel, Matthias (Author) , Süselbeck, Tim (Author) , Schwacke, Harald (Author) , Alonso, Angelika (Author) , Haass, Markus (Author) , Ladwig, Karl-Heinz (Author) , Herrmann-Lingen, Christoph (Author)
Format: Article (Journal)
Language:English
Published: January 2024
In: Journal of psychosomatic research
Year: 2024, Volume: 176, Pages: 1-8
ISSN:1879-1360
DOI:10.1016/j.jpsychores.2023.111542
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.jpsychores.2023.111542
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0022399923003999
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Author Notes:Monika Sadlonova, Stefan Salzmann, Jochen Senges, Christopher M. Celano, Jeff C. Huffman, Martin Borggrefe, Ibrahim Akin, Dierk Thomas, Christopher Jan Schwarzbach, Thomas Kleemann, Steffen Schneider, Matthias Hochadel, Tim Süselbeck, Harald Schwacke, Angelika Alonso, Markus Haass, Karl-Heinz Ladwig, Christoph Herrmann-Lingen

MARC

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520 |a Objective - Atrial fibrillation (AF) is associated with impaired health-related quality of life (HRQoL), an increased risk of morbidity, and mortality. Traditional AF-related outcomes (e.g., AF recurrence) primarily demonstrate the physiological benefits of AF management but do not focus on the benefits experienced subjectively by the patient (i.e., patient-reported outcomes), which have been suggested as optimal endpoints in AF intervention studies. The aim of this study is to identify medical and psychological factors associated with impaired HRQoL at 1-year follow-up. - Methods - Using data from the prospective observational multicenter ARENA study in patients with AF, we analyzed associations between medical factors, anxiety, and HRQoL at 1-year follow-up assessed using 5-level EuroQoL-5D. - Results - In 1353 AF patients (mean age 71.4 ± 10.3 years, 33.8% female), none of the medical predictors (e.g., heart disease) or history of cardioversion were associated with HRQoL at the 1-year follow-up. Higher generalized anxiety (β = -0.114, p < .001) but not cardiac anxiety (β = -0.006, p = .809) at baseline predicted decreased HRQoL, independent of confounding variables and patients' medical status. Furthermore, the worsening of patients' generalized anxiety was associated with decreased HRQoL (ß = -0.091, p < .001). In contrast, the improvement of generalized anxiety over time predicted higher HRQoL (ß = 0.097, p < .001). Finally, the worsening of patients' cardiac anxiety over time was associated with decreased HRQoL (ß = -0.081, p < .001). - Conclusion - Our results highlight the importance of anxiety as a predictor of future HRQoL in patients with AF. Additional studies to examine the impact of anxiety treatment on HRQoL in this population are needed. - Clinical trial registration - The investigators registered on ClinicalTrials.gov (NCT02978248) on November 30, 2016 https://clinicaltrials.gov/ct2/show/NCT02978248. 
650 4 |a Atrial fibrillation 
650 4 |a Cardiac anxiety 
650 4 |a Generalized anxiety 
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