Influence on Health Related Quality of Life by Oral Anticoagulant Usage

Aim. The aim of this study was to examine whether oral anticoagulants have an influence on health related quality of life for persons with high-risk atrial fibrillation.

Materials and methods

This study was held during period from October 2016 till June 2018, including patients with high-risk non-valvular atrial fibrillation. Patients were divided into three groups – VKA (warfarin) users, DOAC users and patients, who did not use any thrombosis prophylaxis for whatever reason. Data basis included modified short form 36 (SF-36) questionnaire.

Results

561 patients were included, 293 (52,2%) female and 268 (47.8%) male with the mean age of 70.7 (SD 9.7) years. The mean CHA2DS2-VASc score was 4.3. The average score in general health for patients who use VKA were 33.2%, DOACs – 40.1%, non-users – 40.9%. Physical functioning for VKA users – 54.0%, DOACs – 70.5%, non-users – 62.3%. Role limitation due to physical health problems for VKA users – 44.2%, DOACs – 58.3%, non-users 56.9%. Emotional well-being for VKA users – 69.6%, DOACs – 73.9%, non-users – 70.3%. Social functioning for VKA users – 67.3%, DOACs – 77.2%, non-users – 77.9%. Role limitation due to personal or emotional problems for VKA users – 52.5%, DOACs – 63.1%, non-users – 61.2%. Energy-fatigue level for VKA users – 47.4%, DOACs – 54.9%, non-users – 50.5%. There was found a statistically significant difference between warfarin users and DOAC users in physical functioning (p=0.002) average scores and energy-fatigue levels (p=0.041). As well a statistically significant difference comparing warfarin users with patients who do not use oral anticoagulant in social functioning scores – p=0.014.

Conclusions

Oral anticoagulant usage correlates with changes in health related quality of life evaluation scores. DOAC usage correlates with statistically significant improvement in physical functioning (p=0.002) and energy-fatigue levels (p=0.041) scores compared to warfarin users. In addition, warfarin usage correlates with worse average evaluation scores in social functioning compared to patients, who did not use any kind of oral anticoagulant.