Health-related quality of life & healthcare costs of symptoms and cardiovascular disease events in patients with atrial fibrillation: a longitudinal analysis of 27 countries from the EORP-AF General Long-Term Registry.

BACKGROUND AND AIMS: We examine the effects of symptoms and cardiovascular disease events on health-related quality of life (HRQOL) and healthcare costs in a European population with atrial fibrillation (AF). METHODS: In the EURObservational Research Programme on AF Long-Term General Registry, AF patients from 250 centres in 27 European countries were enrolled and followed for 2 years. We used fixed effects models to estimate the association of symptoms and cardiovascular disease (CVD) events on HRQOL and annual healthcare costs. RESULTS: We found significant decrements in HRQOL in AF patients in whom STEMI (-0.075 (95% CI -0.144, -0.006)), angina or NSTEMI (-0.037 (-0.071, -0.003)), new onset/worsening heart failure (-0.064 (-0.088, -0.039)), bleeding events (-0.031 (-0.059, -0.003)), thromboembolic events (-0.071 (-0.115, -0.027)), mild symptoms (0.037 (-0.048, -0.026)), or severe/disabling symptoms (-0.090 (-0.108, -0.072)) occurred during the follow-up. During follow-up, annual healthcare costs were associated with an increase of €11718 (€8497, €14939) in patients with STEMI, €5823 (€4757, €6889) in patients with angina/NSTEMI, €3689 (€3219, €4158) in patients with new onset or worsening heart failure, €3792 (€3315, €4270) in patients with bleeding events, and €3182 (€2483, €3881) in patients with thromboembolic events, compared to AF patients without these events. Healthcare costs were primarily driven by inpatient costs. There were no significant differences in HRQOL or healthcare resource use between EU regions or by sex. CONCLUSION: Symptoms and CVD events are associated with a high burden on AF patients and healthcare systems throughout Europe.