Grant: Travel Awards - Institute Community Support

Background: Patients with syncope have a poor health-related quality of life (HRQoL) that is associated with the frequency of syncope. This study examined the change in HRQoL over time in patients with vasovagal syncope who had been seen by a syncope expert and enrolled in a clinical trial. Additionally, the study explored whether the change differed with treatment or fainting during study follow up. Methods: The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) was completed at baseline and 12 months post-enrollment by syncope patients participating in the First and Second Prevention of Syncope Trials (POST and POSTII), which were international, multi-centered trials of metoprolol (POST) and fludrocortisone (POST2) for vasovagal syncope. Paired t-tests compared health-dimension scores between baseline and 12 months. Changes between baseline and 12-month scores were stratified by fainting status and drug randomization, and analyzed using Student's t-test. Results: Data are available on 152 patients (41±17 years; 62% F). From baseline to 12 months, patients reported improved physical functioning (79±24 vs 83±21), vitality (52±22 vs 59±21), mental health (69±19 vs 75±17), general health (66±23 vs 69±21), social functioning (74±26 vs 82±23), as well as reduced bodily pain (69±24 vs 73±23) and role limitations due to both physical health (63±41 vs 72±38) and emotional problems (74±38 vs 83±30). This improvement was consistent across groups - including in patients that fainted in follow-up. Assignment to active drug or placebo did not alter this improvement in HRQoL. Conclusion: HRQoL of syncope patients improves over time; this change is seen regardless of fainting in follow up or randomization to active drug or placebo. These data indicate that the improvement in HRQoL may be a result of alternative factors, such as the interaction with an expert physician or study enrollment.