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Effects of Ablation Versus Drug Therapy on Quality of Life by Sex in Atrial Fibrillation: Results From the CABANA Trial.
Zeitler, Emily P; Li, Yanhong; Silverstein, Adam P; Russo, Andrea M; Poole, Jeanne E; Daniels, Melanie R; Al-Khalidi, Hussein R; Lee, Kerry L; Bahnson, Tristram D; Anstrom, Kevin J; Packer, Douglas L; Mark, Daniel B.
Afiliación
  • Zeitler EP; Dartmouth Health and The Dartmouth Institute Lebanon NH USA.
  • Li Y; Duke Clinical Research Institute, Duke University Durham NC USA.
  • Silverstein AP; Duke Clinical Research Institute, Duke University Durham NC USA.
  • Russo AM; Division of Cardiovascular Disease Cooper Medical School of Rowan University Camden NJ USA.
  • Poole JE; University of Washington Medical Center Seattle WA USA.
  • Daniels MR; Duke Clinical Research Institute, Duke University Durham NC USA.
  • Al-Khalidi HR; Duke Clinical Research Institute, Duke University Durham NC USA.
  • Lee KL; Department of Biostatistics and Bioinformatics Duke University Durham NC USA.
  • Bahnson TD; Duke Clinical Research Institute, Duke University Durham NC USA.
  • Anstrom KJ; Department of Biostatistics and Bioinformatics Duke University Durham NC USA.
  • Packer DL; Duke Clinical Research Institute, Duke University Durham NC USA.
  • Mark DB; Division of Cardiology, Department of Medicine Duke University Medical Center Durham NC USA.
J Am Heart Assoc ; 12(3): e027871, 2023 02 07.
Article en En | MEDLINE | ID: mdl-36688367
Background Women with atrial fibrillation (AF) demonstrate more AF-related symptoms and worse quality of life (QOL). Whether increased use of ablation in women reduces sex-related QOL differences is unknown. Sex-related outcomes for ablation versus drug therapy was a prespecified analysis in the CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial. Methods and Results Symptoms were assessed periodically over 60 months with the Mayo AF-Specific Symptom Inventory (MAFSI) frequency score, and QOL was assessed with the Atrial Fibrillation Effect on Quality of Life (AFEQT) summary and component scores. Women had lower baseline QOL scores than men (mean AFEQT scores 55.9 and 65.6, respectively). Ablation patients improved more than drug therapy patients with similar treatment effect by sex: AFEQT 12-month mean adjusted treatment difference in women 6.1 points (95% CI, 3.5-8.6) and men 4.9 points (95% CI, 3.0-6.9). Participants with baseline AFEQT summary scores <70 had greater QOL improvement, with a mean treatment difference at 12 months of 7.6 points for women (95% CI, 4.3-10.9) and 6.4 points for men (95% CI, 3.3-9.4). The mean adjusted difference in MAFSI frequency score between women randomized to ablation versus drug therapy at 12 months was -2.5 (95% CI, -3.4 to -1.6); for men, the difference was -1.3 (95% CI, -2.0 to -0.6). Conclusions Compared with drug therapy for AF, ablation resulted in more QOL improvement in both sexes, primarily driven by improvements in those with lower baseline QOL. Ablation did not eliminate the AF-related QOL gap between women and men. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00911508.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Ablación por Catéter Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Aspecto: Patient_preference Límite: Female / Humans / Male Idioma: En Revista: J Am Heart Assoc Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Ablación por Catéter Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Aspecto: Patient_preference Límite: Female / Humans / Male Idioma: En Revista: J Am Heart Assoc Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido