Prospective assessment of sex-related differences in symptom status and health perception among patients with atrial fibrillation

Background-we 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 (β=-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). conclusions-women 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. © 2017 the authors.