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Factors associated with low health-related quality of life among younger and older Thai patients with non-valvular atrial fibrillation

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Abstract

Purpose

The aim of this study was to investigate the factors associated with low health-related quality of life (HRQoL) compared between younger and older Thai patients with non-valvular atrial fibrillation (NVAF).

Methods

This is a cross-sectional analysis of baseline data from a prospective NVAF registry from 24 hospitals located across Thailand. Patient demographic, clinical, lifestyle, and medication data were collected at baseline. EuroQOL/EQ-5D-3L was used to assess HRQoL. Health utility was calculated for the entire study population, and low HRQoL was defined as the lowest quartile. Multivariate logistic regression was used to identify factors that significantly predict low HRQoL among younger and older (≥ 65 years) patients with NVAF.

Results

Among the 3218 participants that were enrolled, 61.0% were aged older than 65 years. Mean HRQoL was lower in older than in younger patients (0.72 ± 0.26 vs. 0.84 ± 0.20; p < 0.001). Factors associated with low HRQoL among younger NVAF patients were the treatment-related factors bleeding history (p = 0.006) and taking warfarin (p = 0.001). Among older patients, the NVAF-related complications ischemic stroke or TIA, heart failure (HF), and dementia (all p < 0.001) were all significantly associated with low HRQoL. Dementia is the factor that most adversely influences low HRQoL among older NVAF. Interestingly, symptomatic NVAF was found to be a protective factor for low HRQoL (p < 0.001).

Conclusions

Bleeding history and taking warfarin among younger patients, and ischemic stroke/TIA, HF, and dementia among older patients are significant predictors of low HRQoL. These factors should be taken into consideration when selecting treatment options for patients with NVAF.

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Acknowledgements

The authors gratefully acknowledge the patients that generously agreed to participate in this study, and Dr. Suthipol Udompanturak of the Division of Clinical Epidemiology, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University for assistance with statistical analysis. Buddhachinaraj Hospital: Tomorn Thongsri, MD; Central Chest Institute of Thailand: Kriengkrai Hengrussamee, MD; Charoen Krung Pracha Rak Hospital: Pattraporn Srirattana, MD; Chiangrai Prachanukroh Hospital: Wattana Wongtheptien, MD; Chonburi Hospital: Pornchai Ngamjanyaporn, MD; Faculty of Medicine, Chiang Mai University: Arintaya Phrommintikul, MD; Faculty of Medicine, Chulalongkorn University: Smonporn Boonyaratavej, MD; Faculty of Medicine, Naresuan University: Pongpun Jittham, MD; Faculty of Medicine, Prince of Songkla University: Treechada Wisaratapong, MD; Faculty of Medicine Ramathibodi Hospital, Mahidol University: Sirin Apiyasawat, MD; Faculty of Medicine Siriraj Hospital, Mahidol University: Arjbordin Winijkul, MD, Rungroj Krittayaphong, MD; Faculty of Medicine, Thammasat University (Rangsit Campus): Roj Rojjarekampai, MD; Faculty of Medicine Vajira Hospital, Navamindradhiraj University: Kulyot Jongpiputvanich, MD; Golden Jubilee Medical Center: Somchai Dutsadeevettakul, MD; Srinakarind Hospital, Faculty of Medicine, Khon Kaen University: Chaiyasith Wongvipaporn, MD; Lampang Hospital: Thanita Boonyapiphat, MD; Maharat Nakorn Ratchasima Hospital: Weerapan Wiwatworapan, MD; Nakornping Hospital: Khanchai Siriwattana, MD; Pattani Hospital: Eakarnantha Arnanththanitha, MD; Photharam Hospital: Watchara Konkaew, MD; Phramongkutklao College of Medicine: Thoranis Chantrarat, MD; Police General Hospital: Kasem Ratanasumawong, MD; Prapokklao Hospital (Chanthaburi): Wiwat Kanjanarutjawiwat, MD; Queen Savang Vadhana Memorial Hospital: Sakaorat Kornbongkotmas; MD; Ratchaburi Hospital: Thanasak Patmuk, MD; Sapphasitthiprasong Hospital: Praprut Thanakitcharu, MD; Surat Thani Hospital: Suchart Arunsiriwattana, MD; Surin Hospital: Thaworn Choochunklin; MD; Udon Thani Hospital: Sumon Tangsuntornwiwat, MD.

Funding

This study was funded by the Health Systems Research Institute (HSRI), Nonthaburi, Thailand (Grant No. 59-053), The Heart Association of Thailand under the Royal Patronage of H.M. the King, Bangkok, Thailand, and The Royal College of Physicians of Thailand, Bangkok, Thailand.

Author information

Authors and Affiliations

  1. Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Varalak Srinonprasert, Rungroj Krittayaphong, Arjbordin Winijkul & Rungroj Krittayaphong

  2. Police General Hospital, Bangkok, Thailand

    Kasem Ratanasumawong & Kasem Ratanasumawong

  3. Buddhachinaraj Hospital, Phitsanulok, Thailand

    Tomon Thongsri & Tomorn Thongsri

  4. Golden Jubilee Medical Center, Nakhon Pathom, Thailand

    Somchai Dutsadeevettakul & Somchai Dutsadeevettakul

  5. Naresuan University, Phitsanulok, Thailand

    Pongpun Jittham & Pongpun Jittham

  6. Maharat Nakorn Ratchasima Hospital, Nakorn Ratchasima, Thailand

    Weerapan Wiwatworapan & Weerapan Wiwatworapan

  7. Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand

    Rungroj Krittayaphong

Authors
  1. Varalak Srinonprasert
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  2. Kasem Ratanasumawong
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  3. Tomon Thongsri
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  4. Somchai Dutsadeevettakul
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  5. Pongpun Jittham
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  6. Weerapan Wiwatworapan
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  7. Rungroj Krittayaphong
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Consortia

COOL AF Investigators

  • Tomorn Thongsri
  • , Kriengkrai Hengrussamee
  • , Pattraporn Srirattana
  • , Wattana Wongtheptien
  • , Pornchai Ngamjanyaporn
  • , Arintaya Phrommintikul
  • , Smonporn Boonyaratavej
  • , Pongpun Jittham
  • , Treechada Wisaratapong
  • , Sirin Apiyasawat
  • , Arjbordin Winijkul
  • , Rungroj Krittayaphong
  • , Roj Rojjarekampai
  • , Kulyot Jongpiputvanich
  • , Somchai Dutsadeevettakul
  • , Chaiyasith Wongvipaporn
  • , Thanita Boonyapiphat
  • , Weerapan Wiwatworapan
  • , Khanchai Siriwattana
  • , Eakarnantha Arnanththanitha
  • , Watchara Konkaew
  • , Thoranis Chantrarat
  • , Kasem Ratanasumawong
  • , Wiwat Kanjanarutjawiwat
  • , Sakaorat Kornbongkotmas
  • , Thanasak Patmuk
  • , Praprut Thanakitcharu
  • , Suchart Arunsiriwattana
  • , Thaworn Choochunklin
  •  & Sumon Tangsuntornwiwat

Corresponding author

Correspondence to Rungroj Krittayaphong.

Ethics declarations

Conflict of interest

All authors declare no personal or professional conflicts of interest.

Ethical approval

The protocol for this study was approved by the institutional review boards of the Thailand Ministry of Public Health and all participating hospitals. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

All patients provided written informed consent prior to participation.

Additional information

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

COOL AF Investigators members of the group are listed in Acknowledgements.

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Srinonprasert, V., Ratanasumawong, K., Thongsri, T. et al. Factors associated with low health-related quality of life among younger and older Thai patients with non-valvular atrial fibrillation. Qual Life Res 28, 2091–2098 (2019). https://doi.org/10.1007/s11136-019-02171-3

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  • DOI: https://doi.org/10.1007/s11136-019-02171-3

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