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Effect of novel oral anticoagulants on Hospital Anxiety and Depression Scale scores

Auswirkungen neuer oraler Antikoagulanzien auf den Punktwert in der Hospital Anxiety and Depression Scale

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Abstract

Background

The negative impact of atrial fibrillation (AF) on health-related quality of life has been extensively documented. The aim of this study was to compare the Hospital Anxiety and Depression Scale (HADS) scores of patients with non-valvular AF during warfarin administration and after switching to novel oral anticoagulants (NOACs).

Methods

The study comprised 100 consecutive patients on warfarin treatment between July 2018 and January 2019 for whom a transition to NOACs was planned. All patients completed the HADS at the start of the study and at least 3 months after that date.

Results

The mean value of HADS-A (5.9 ± 2.1 vs. 4.4 ± 1.6, p < 0.001) and HADS-D (4.4 ± 1.7 vs. 3.7 ± 1.4, p < 0.001) scores was significantly higher in patients when they used warfarin than when they switched to NOACs. Analysis revealed that there was a significant correlation between HADS-A and HADS-D scores with age and history of bleeding (p < 0.001). The highest scores were found for patients with a history of bleeding and age ≥75 years (p < 0.001).

Conclusion

Our study demonstrates that patients with nonvalvular AF under treatment with NOACs had lower HADS-A and HADS-D scores compared with patients on warfarin treatment. These findings suggest that NOACs may increase the quality of life and decrease morbidity and mortality by reducing anxiety and depression.

Zusammenfassung

Hintergrund

Der negative Einfluss von Vorhofflimmern (VF) auf die gesundheitsbezogene Lebensqualität ist ausführlich dokumentiert worden. Ziel der vorliegenden Studie war es, die Punktwerte in der Hospital Anxiety and Depression Scale (HADS) von Patienten mit nichtvalvulärem VF unter Warfaringabe und nach Wechsel zu neuen oralen Antikoagulanzien (NOAK) zu vergleichen.

Methoden

Diese Studie umfasst 100 Patienten unter Therapie mit Warfarin, die sich zwischen Juli 2018 und Januar 2019 konsekutiv vorstellten und bei denen eine Umstellung auf NOAK geplant war. Alle Patienten füllten die HADS zu Beginn der Studie und mindestens 3 Monate später aus.

Ergebnisse

Der Mittelwert der Punktwerte für die HADS-A (5,9 ± 2,1 vs. 4,4 ± 1,6; p < 0,001) und HADS-D (4,4 ± 1,7 vs. 3,7 ± 1,4; p < 0,001) war bei Patienten unter Warfarin signifikant höher als beim Wechsel zu NOAK. Die Auswertung ergab, dass eine signifikante Korrelation zwischen den Punktwerten für HADS-A bzw. HADS-D und dem Alter sowie der Anamnese in Bezug auf Blutungen bestand (p < 0,001). Die höchsten Werte fanden sich bei Patienten mit Blutungen in der Anamnese und einem Alter ≥75 Jahre (p < 0,001).

Schlussfolgerung

Die vorliegende Studie ergab, dass Patienten mit nichtvalvulärem VF unter Therapie mit NOAK niedrigere Punktwerte für HADS-A und HADS-D aufwiesen als Patienten unter Behandlung mit Warfarin. Diese Ergebnisse liefern einen Hinweis darauf, dass NOAK möglicherweise durch eine Verminderung von Angst und Depression die Lebensqualität steigern und Morbidität sowie Mortalität senken können.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Education and Research Hospital, Department of Cardiology, Sakarya University, 54100, Sakarya, Turkey

    K. Cosansu MD & S. Yılmaz

  2. Department of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey

    C. M. Ureyen MD

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  1. K. Cosansu MD
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  2. C. M. Ureyen MD
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  3. S. Yılmaz
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Correspondence to K. Cosansu MD.

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Conflict of interest

K. Coşansu, C.M. Ureyen, and S. Yılmaz declare that they have no competing interests.

All studies performed were in accordance with the ethical standards indicated in each case. This study complied with the Declaration of Helsinki, and it was approved by the independent medical ethics committee of Sakarya University Education and Research Hospital.

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Cosansu, K., Ureyen, C.M. & Yılmaz, S. Effect of novel oral anticoagulants on Hospital Anxiety and Depression Scale scores. Herz 44, 743–749 (2019). https://doi.org/10.1007/s00059-019-4828-1

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  • DOI: https://doi.org/10.1007/s00059-019-4828-1

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