Comparison of health-related quality of life among patients using novel oral anticoagulants or warfarin for non-valvular atrial fibrillationKevser Gülcihan Balcı, Mustafa Mücahit Balcı, Uğur Canpolat, Fatih Şen, Mehmet K. Akboğa, Muhammed Süleymanoğlu, Serdar Kuyumcu, Orhan Maden, Hatice Selçuk, Mehmet Timur Selçuk
Department Of Cardiology, Türkiye Yüksek İhtisas Research And Education Hospital; Ankara- Turkey
Objective: The aim of this study was to compare health-related quality of life (HRQoL) measures between novel oral anticoagulants (NOACs) and warfarin-treated Turkish patients who had been started on oral anticoagulants (OACs) due to non-valvular atrial fibrillation (AF) and to determine the effects of OACs on patients emotional status, anxiety and depression.Keywords: atrial fibrillation, warfarin, apixaban, dabigatran, quality of life, anxiety
Methods: A total of 182 patients older than 18 years with non-valvular AF and being treated with OACs for at least 6 months according to current AF guidelines who were admitted to outpatient clinics between July 2014 and January 2015 were included in this cross-sectional study. The exclusion criteria were receiving OACs for conditions other than non-valvular AF and being unable to answer the questionnaire. A questionnaire was administered to all participants to evaluate HRQoL, depression and anxiety. The mean differences between the groups were compared using Students t-test; the MannWhitney U test was applied for comparisons of the medians.
Results: The annual number of hospital admissions was significantly higher in the warfarin group (p<0.001), and all HRQoL scores were significantly lower and Hospital Anxiety and Depression Scale (HADS) score was higher in the warfarin group (p<0.001). History of any type of bleeding was significantly higher in the warfarin group (p<0.001). However, none of the patients had major bleeding. Among patients who experienced bleeding, all HRQoL scores were significantly lower and HADS score was significantly higher (p<0.001 and p=0.002, respectively).
Conclusion: Warfarin-treated patients had higher levels of self-reported symptoms of depression and anxiety and compromised HRQoL when compared with NOAC-treated patients. The results may be explained by higher rates of bleeding episodes and higher number of hospital admissions, which may cause restrictions in life while on warfarin treatment. (Anatol J Cardiol 2016; 16: 474-81)
Kevser Gülcihan Balcı, Mustafa Mücahit Balcı, Uğur Canpolat, Fatih Şen, Mehmet K. Akboğa, Muhammed Süleymanoğlu, Serdar Kuyumcu, Orhan Maden, Hatice Selçuk, Mehmet Timur Selçuk. Comparison of health-related quality of life among patients using novel oral anticoagulants or warfarin for non-valvular atrial fibrillation. Anatol J Cardiol. 2016; 16(7): 474-481
Corresponding Author: Kevser Gülcihan Balcı, Türkiye