1
|
Guerrero-Márquez FJ, Sainz-Hidalgo I, Cristobo Sainz P, Sigler Vilches I, Avilés Toscano A, Soto-Espinosa de Los Monteros B. [Effectiveness of the EQ-5D and CRES-4 questionnaire for assessing the impact on the quality of life of patients and the level of satisfaction after exchanging dicumarinics for edoxabán: Real-life experience based on a multicentre study]. Med Clin (Barc) 2021; 157:530-534. [PMID: 33059936 DOI: 10.1016/j.medcli.2020.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/09/2020] [Accepted: 07/15/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Atrial fibrillation and anticoagulation decrease the quality of life of patients. The aim of this study is to assess the quality of life and the degree of satisfaction after changing from VKA to edoxaban anticoagulants. MATERIAL AND METHODS Prospective, multicentre study, including 105 patients in dicumarinic anticoagulant treatment replaced by edoxaban. Their quality of life was evaluated before and after using the EQ-5D questionnaire, and the degree of satisfaction with CRES-4 scale. RESULTS Average 75 years, CHA2DS2VASC3,5 and HASBLED2,1; thromboembolic events and clinically relevant bleeding during follow-up <1%. EQ-5D showed a significant overall improvement in the mobility and anxiety parameters (P=.023, 95%CI: .0175-.23; P=.019, 95%CI:=.028-.31). The CRES-4 questionnaire showed satisfaction with the therapist of 95%, a positive impact on life of 73% and a negative impact of 3.8%. The emotional state attributed to the change in treatment improved (41% vs 69.5%, P=.0001). The final score of the CRES-4 weakly correlated with the emotional situation of the EQ-5D questionnaire. CONCLUSIONS The change of anticoagulant for edoxaban improves the quality of life and the degree of patient satisfaction, and the EQ-5D and CRES-4 quality of life questionnaires can be used complementarily.
Collapse
Affiliation(s)
| | - Ignacio Sainz-Hidalgo
- Área del Corazón, Servicio de Cardiología, Hospital Virgen del Rocío, Sevilla, España
| | - Pablo Cristobo Sainz
- Área del Corazón, Servicio de Cardiología, Hospital Virgen del Rocío, Sevilla, España
| | | | - Alberto Avilés Toscano
- Departamento de Cardiología, Servicio de Medicina Interna, Hospital de la Serranía, Ronda, Málaga, España
| | | |
Collapse
|
2
|
López-Sendón JL, Alonso-Rodríguez D, Barón-Esquivias G, Cosin-Sales J, Marín F, Galera-Llorca J, Jiménez N, Marler S, Huisman MV, Lip GYH. Gender differences in antithrombotic treatment in patients with atrial fibrillation from Spain versus the rest of Western Europe. GLORIA-AF Program. Med Clin (Barc) 2021; 159:177-182. [PMID: 34895750 DOI: 10.1016/j.medcli.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Thromboembolic risk is higher in women than men with non-valvular atrial fibrillation (NVAF). Published data indicate variability in antithrombotic use by gender and region. We analyzed gender-specific antithrombotic treatment patterns in Spain and rest of Western Europe (rWE) in patients with NVAF. METHODS GLORIA-AF (Phase III) is a global, prospective, observational study which enrolled newly diagnosed NVAF patients with CHA2DS2-VAScs≥1 (2014-2016). Analyses were performed comparing antithrombotic treatments by gender in Spain and rWE. RESULTS This analysis included 1163 and 7972 patients from Spain and rWE, respectively. Stroke risk was higher in women than men in both Spain and rWE. While in rWE, bleeding risk and antithrombotic treatment pattern were similar between genders, in Spain bleeding risk in women was lower and more females compared to men received OACs (95.0% versus 92.4%, d=-0.1078, respectively). Fewer Spanish patients received direct oral anticoagulants (DOACs) (women 32.1%, men 25.3%) than vitamin-K-antagonists (VKAs) (women 63.0%, men 67.1%) vs. rWE patients. In Spain women received more DOACs compared to men (56.0% versus 44.0%). CONCLUSIONS OAC rates were higher in Spain as compared to rWE. More women received OACs in Spain, while in rWE no difference by gender was observed. DOACs in rWE are the most prescribed OAC while in Spain, due to prescription barriers, its use remains low for both genders and VKAs are preferred. Spanish women received more DOACs compared to men. (NCT01468701).
Collapse
Affiliation(s)
- José L López-Sendón
- Hospital Universitario La Paz, IDIPAZ, CIBER-CV, Paseo de la Castellana 261, 28046 Madrid, Spain.
| | | | | | - Juan Cosin-Sales
- Hospital Arnau de Vilanova, Carrer de Sant Clement, 12, 46015 Valencia, Spain
| | - Francisco Marín
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, Ctra. Madrid-Cartagena, s/n, Murcia, Spain
| | | | - Natalia Jiménez
- Boehringer Ingelheim Spain, Carrer de Prat de la Riba, 50, 08174 Sant Cugat del Vallès, Barcelona, Spain
| | - Sabrina Marler
- Boehringer Ingelheim Pharmaceuticals Inc, 900 Ridgebury Rd, Ridgefield, CT 06877, USA
| | - Menno V Huisman
- Leiden University Medical Centre, Leiden, Albinusdreef 2, 2333 ZA Leiden, Netherlands
| | - Gregory Y H Lip
- University of Liverpool and Liverpool Heart & Chest, Thomas Dr, Liverpool L14 3PE, UK
| | | |
Collapse
|
3
|
Caro Martínez C, Elvira Ruiz G, Flores Blanco PJ, Cerezo Manchado JJ, Albendín Iglesias H, Lova Navarro A, Arregui Montoya F, García Alberola A, Pascual Figal DA, Bailén Lorenzo JL, Manzano Fernández S. Prevalence and Prognostic Implications of Valve Disease in Patients With Atrial Fibrillation Initiating Direct Oral Anticoagulants. Rev Esp Cardiol (Engl Ed) 2019; 72:935-943. [PMID: 30497945 DOI: 10.1016/j.rec.2018.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/09/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION AND OBJECTIVES Valvular heart disease in patients with atrial fibrillation included in clinical trials with direct oral anticoagulants (DOAC) is common and is associated with worse prognosis. The aim of this study was to evaluate the prevalence of valvular heart disease and its influence on clinical events in real-world clinical practice. METHODS We conducted a retrospective multicenter registry including 2297 consecutive patients with nonvalvular atrial fibrillation initiating DOAC between January 2013 and December 2016. Valvular heart disease was defined as moderate or severe involvement. The primary study endopoint was the composite of death, stroke or transient ischemic attack/systemic embolism or major bleeding. A competing risks analysis was carried out using a Fine and Gray regression model, with death being the competing event. RESULTS A total of 499 (21.7%) patients had significant valvular heart disease. The most common form was mitral regurgitation (13.7%). Patients with valvular heart disease were older and had more comorbidities. After multivariable analysis, valvular heart disease was associated with a higher risk for the primary endpoint (HR, 1.54; 95%CI, 1.22-1.94; P<.001), death (HR, 1.44; 95%CI, 1.09-1.91, P=.010), and major bleeding (HR, 1.85; 95%CI, 1.23-2.79, P=.003), but there was no association with thromboembolic events (P >.05). CONCLUSIONS In patients with nonvalvular atrial fibrillation initiating DOACs, valvular heart disease is common and increases the risk of mortality, stroke, transient ischemic attack/systemic embolism, and major bleeding complications. These findings confirm the results of clinical trials and expand them to a real-life clinical setting.
Collapse
Affiliation(s)
- César Caro Martínez
- Servicio de Cardiología, Hospital Vega Baja, Orihuela, Alicante, Spain; Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain
| | - Ginés Elvira Ruiz
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Pedro J Flores Blanco
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Juan José Cerezo Manchado
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Hematología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Helena Albendín Iglesias
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Medicina Interna, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Alejandro Lova Navarro
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Francisco Arregui Montoya
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Arcadio García Alberola
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Departamento de Medicina Interna, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - Domingo Andrés Pascual Figal
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Departamento de Medicina Interna, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | | | - Sergio Manzano Fernández
- Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain; Departamento de Medicina Interna, Facultad de Medicina, Universidad de Murcia, Murcia, Spain.
| |
Collapse
|