Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Jul 2017)

Prospective Assessment of Sex‐Related Differences in Symptom Status and Health Perception Among Patients With Atrial Fibrillation

  • Steffen Blum,
  • Christoph Muff,
  • Stefanie Aeschbacher,
  • Peter Ammann,
  • Paul Erne,
  • Giorgio Moschovitis,
  • Marcello Di Valentino,
  • Dipen Shah,
  • Jürg Schläpfer,
  • Andreas Fischer,
  • Tamara Merkel,
  • Michael Kühne,
  • Christian Sticherling,
  • Stefan Osswald,
  • David Conen

DOI
https://doi.org/10.1161/JAHA.116.005401
Journal volume & issue
Vol. 6, no. 7

Abstract

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BackgroundWe prospectively assessed sex‐specific differences in health perception, overall symptom status, and specific symptoms in a large cohort of patients with atrial fibrillation. Methods and ResultsWe performed a prospective multicenter observational cohort study of 1553 patients with atrial fibrillation. Patients completed questionnaires about personal characteristics, comorbidities, and symptoms on a yearly basis. Mean age was 70±11 years among women and 67±12 years among men. Health perception on a visual analogue scale ranging from 0 to 100 (with higher scores indicating better health perception) was significantly lower in women than in men (70 [interquartile range: 50–80] versus 75 [interquartile range: 60–85]; P<0.0001). More women than men had any symptoms (85.0% versus 68.3%; P<0.0001), palpitations (65.2% versus 44.4%; P<0.0001), dizziness (25.6% versus 13.5%; P<0.0001), dyspnea (35.7% versus 21.8%; P<0.0001), and fatigue (25.3% versus 19.1%; P=0.006). At 1‐year follow‐up, symptoms decreased in both sexes but remained more frequent in women (49.1% versus 32.6%, P<0.0001). In multivariable adjusted longitudinal regression models, female sex remained an independent predictor for lower health perception (ß=−4.8; 95% CI, −6.5 to −3.1; P<0.0001), any symptoms (odds ratio [OR]: 2.6; 95% CI, 2.1–3.4; P<0.0001), palpitations (OR: 2.6; 95% CI, 2.1–3.2; P<0.0001), dizziness (OR: 2.9; 95% CI, 2.1–3.9; P<0.0001), dyspnea (OR: 2.1; 95% CI, 1.6–2.8; P<0.0001), fatigue (OR: 1.6; 95% CI, 1.2–2.2; P=0.0008), and chest pain (OR: 1.8; 95% CI, 1.3–2.6; P=0.001). ConclusionsWomen with atrial fibrillation have a substantially higher symptom burden and lower health perception than men. These relationships persisted after multivariable adjustment and during prospective follow‐up.

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