Scripties UMCG - Rijksuniversiteit Groningen
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Targeted therapy of underlying conditions improves quality of life in patients with persistent atrial fibrillation: results from the RACE 3 study

(2018) Zwartkruis, V. (Victor)

Background: Atrial fibrillation (AF) reduces quality of life (QoL). This study aimed to evaluate the effects of targeted therapy of underlying conditions on QoL in patients with early persistent AF and mild to moderate heart failure.
Methods: QoL was analysed in 230 patients included in the Routine versus Aggressive risk factor driven upstream rhythm Control for prevention of Early atrial fibrillation in heart failure (RACE 3) study. Patients were randomised to receive conventional therapy or targeted therapy on top of conventional therapy, including mineralocorticoid receptor antagonists, statins, angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers, and cardiac rehabilitation. QoL was assessed at baseline and 1 year using the Medical Outcomes Study Short-Form Health Survey (SF-36) questionnaire.
Results: Both groups improved significantly on the majority of scores analysed. The targeted therapy group demonstrated significantly larger improvements of physical functioning (12±19 versus 6±22, p=0.007), physical role limitations (32±41 versus 17±45, p=0.018), and general health (8±16 versus 0±17, p<0.001) than the conventional group. In patients in AF at 1 year, physical functioning (9±9 versus -3±16.5 , p=0.001), general health (7±16.5 versus -7±19, p=0.004), and social functioning (6±23 versus -4±16, p=0.041) improved significantly more in the intervention group than the conventional group.
Conclusions: A strategy aiming to treat underlying conditions improves physical functioning, physical role limitations, and general health significantly more than conventional therapy in patients with early persistent AF and mild to moderate heart failure. Differences in QoL between groups were more apparent in patients who were in AF at 1 year.

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