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