title: Comparison of health-related quality of life among patients using novel oral anticoagulants or warfarin for non-valvular atrial fibrillation.
abstract: 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 patient's emotional status, anxiety and depression.
  
  
  
  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 Student's t-test; the Mann-Whitney U test was applied for comparisons of the medians.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Cardiology, Türkiye Yüksek İhtisas Research and Education Hospital; Ankara-Turkey. kevs84@gmail.com.
authors.forename: Kevser Gülcihan
authors.initials: KG
authors.lastname: Balcı
authors.forename: Mustafa Mücahit
authors.initials: MM
authors.lastname: Balcı
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Fatih
authors.initials: F
authors.lastname: Şen
authors.forename: Mehmet K
authors.initials: MK
authors.lastname: Akboğa
authors.forename: Muhammed
authors.initials: M
authors.lastname: Süleymanoğlu
authors.forename: Serdar
authors.initials: S
authors.lastname: Kuyumcu
authors.forename: Orhan
authors.initials: O
authors.lastname: Maden
authors.forename: Hatice
authors.initials: H
authors.lastname: Selçuk
authors.forename: Mehmet Timur
authors.initials: MT
authors.lastname: Selçuk