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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We would first like to thank the authors for their interest in our study&#44; which included more than 1000 patients with nonvalvular atrial fibrillation and at high thromboembolic risk&#46; The patients started treatment either with vitamin K antagonists or with dabigatran in the month prior to inclusion in the study&#46; After 6 months of treatment&#44; the quality of life did not change substantially for the group taking the vitamin K antagonists&#59; however&#44; the quality of life did improve significantly for the patient group treated with dabigatran&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">However&#44; the authors were surprised by the use of the validated AF-QoL<span class="elsevierStyleHsp" style=""></span>18 questionnaire to reach this conclusion&#44; because the initial validation of the questionnaire was conducted at 3 months of follow-up&#46; We would like to clarify certain aspects on this issue&#46; Our study has certain clinical relevance&#44; because atrial fibrillation and anticoagulation with vitamin K antagonists are associated with a worsening of quality of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> It is therefore important to understand whether the new anticoagulant treatments can improve this aspect that is so relevant to patients&#8217; lives&#46; Moreover&#44; we do not fully understand the reference chosen by the authors for this criticism&#44; given that the citation corresponds to a different questionnaire &#40;AFEQT&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Although it is true that the AF-QoL<span class="elsevierStyleHsp" style=""></span>18 questionnaire was initially validated to assess health-related quality of life at 3 months of follow-up&#44; the researchers themselves indicated that given the results&#44; it is likely that this questionnaire is able to detect changes in quality of life in longer follow-ups&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> In fact&#44; several recently published studies employed the AF-QoL<span class="elsevierStyleHsp" style=""></span>18 questionnaire for follow-ups of up to 1<span class="elsevierStyleHsp" style=""></span>year&#44; with consistent results&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Given that patients with atrial fibrillation need to undergo long-term anticoagulant therapy&#44; we considered that conducting a quality-of-life study that was limited to the first 3 months of treatment would be insufficient for truly perceiving the quality of life associated with anticoagulant therapy&#46; We therefore considered a follow-up period of 6 months&#46; Our study observed a progressive improvement in quality of life with dabigatran&#46; Although the improvement began in the first month of follow-up&#44; it became more intense in month 6&#46; It is quite possible that with a shorter follow-up period &#40;3 months&#41;&#44; this progression in improving the quality of life might not have been detected with sufficient intensity&#46;</p></span>"
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Correspondence
Reply to “On the quality-of-life questionnaires in atrial fibrillation”
Réplica a «Sobre los cuestionarios de calidad de vida en fibrilación auricular»
V. Barriosa,
Corresponding author
vivenciobarrios@gmail.com

Corresponding author.
, C. Escobarb
a Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
b Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain

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