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Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure
BACKGROUND: Improving health‐related quality of life is an important goal in the management of patients with heart failure (HF). Defining health‐related quality of life changes over time in patients with HF with preserved (HFpEF) or reduced ejection fraction and showing their association with other...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660771/ https://www.ncbi.nlm.nih.gov/pubmed/32812460 http://dx.doi.org/10.1161/JAHA.120.017278 |
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author | Sepehrvand, Nariman Savu, Anamaria Spertus, John A. Dyck, Jason R. B. Anderson, Todd Howlett, Jonathan Paterson, Ian Oudit, Gavin Y Kaul, Padma McAlister, Finlay A. Ezekowitz, Justin A. |
author_facet | Sepehrvand, Nariman Savu, Anamaria Spertus, John A. Dyck, Jason R. B. Anderson, Todd Howlett, Jonathan Paterson, Ian Oudit, Gavin Y Kaul, Padma McAlister, Finlay A. Ezekowitz, Justin A. |
author_sort | Sepehrvand, Nariman |
collection | PubMed |
description | BACKGROUND: Improving health‐related quality of life is an important goal in the management of patients with heart failure (HF). Defining health‐related quality of life changes over time in patients with HF with preserved (HFpEF) or reduced ejection fraction and showing their association with other important clinical events could support the use of health‐related quality of life as a measure of quantifying HF care. METHODS AND RESULTS: In the Alberta HEART (Heart Failure Aetiology and Analysis Team) cohort (n=621), patients were categorized into 4 subgroups: healthy controls (n=98), at risk (n=163), HFpEF (n=191), and HF with reduced ejection fraction (n=169). The change of the Kansas City Cardiomyopathy Questionnaire (KCCQ), EuroQOL 5 dimensions, and Functional Assessment of Cancer Therapy—Anemia over 12 months, and its association with a composite of death or rehospitalization within 3 years were assessed. At baseline, the KCCQ overall summary score was 73 (interquartile range, 53–86) in HFpEF and 78 (interquartile range, 56–90) in HF with reduced ejection fraction (P=0.22). Overall, 30.5% of patients with HF experienced ≥5‐point improvements and 32.4% had ≥5‐point worsening in KCCQ overall summary score at 12 months, which did not differ between HFpEF and HF with reduced ejection fraction (P=0.23). Clinical events were higher in patients with HF who had a decline in KCCQ over 12 months as compared with those with stable KCCQ scores (70.2% versus 52.0%, P=0.012). The results were similar for the Functional Assessment of Cancer Therapy—Anemia and EuroQOL 5 dimensions. CONCLUSIONS: In patients with HF, the KCCQ quantified clinically meaningful changes over time, which were associated with important clinical outcomes in patients with HFpEF. Given the observed variability and prognostication in different patient trajectories, health‐related quality of life measures could be valuable for quantifying the quality of care in healthcare systems. |
format | Online Article Text |
id | pubmed-7660771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76607712020-11-17 Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure Sepehrvand, Nariman Savu, Anamaria Spertus, John A. Dyck, Jason R. B. Anderson, Todd Howlett, Jonathan Paterson, Ian Oudit, Gavin Y Kaul, Padma McAlister, Finlay A. Ezekowitz, Justin A. J Am Heart Assoc Original Research BACKGROUND: Improving health‐related quality of life is an important goal in the management of patients with heart failure (HF). Defining health‐related quality of life changes over time in patients with HF with preserved (HFpEF) or reduced ejection fraction and showing their association with other important clinical events could support the use of health‐related quality of life as a measure of quantifying HF care. METHODS AND RESULTS: In the Alberta HEART (Heart Failure Aetiology and Analysis Team) cohort (n=621), patients were categorized into 4 subgroups: healthy controls (n=98), at risk (n=163), HFpEF (n=191), and HF with reduced ejection fraction (n=169). The change of the Kansas City Cardiomyopathy Questionnaire (KCCQ), EuroQOL 5 dimensions, and Functional Assessment of Cancer Therapy—Anemia over 12 months, and its association with a composite of death or rehospitalization within 3 years were assessed. At baseline, the KCCQ overall summary score was 73 (interquartile range, 53–86) in HFpEF and 78 (interquartile range, 56–90) in HF with reduced ejection fraction (P=0.22). Overall, 30.5% of patients with HF experienced ≥5‐point improvements and 32.4% had ≥5‐point worsening in KCCQ overall summary score at 12 months, which did not differ between HFpEF and HF with reduced ejection fraction (P=0.23). Clinical events were higher in patients with HF who had a decline in KCCQ over 12 months as compared with those with stable KCCQ scores (70.2% versus 52.0%, P=0.012). The results were similar for the Functional Assessment of Cancer Therapy—Anemia and EuroQOL 5 dimensions. CONCLUSIONS: In patients with HF, the KCCQ quantified clinically meaningful changes over time, which were associated with important clinical outcomes in patients with HFpEF. Given the observed variability and prognostication in different patient trajectories, health‐related quality of life measures could be valuable for quantifying the quality of care in healthcare systems. John Wiley and Sons Inc. 2020-08-19 /pmc/articles/PMC7660771/ /pubmed/32812460 http://dx.doi.org/10.1161/JAHA.120.017278 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Sepehrvand, Nariman Savu, Anamaria Spertus, John A. Dyck, Jason R. B. Anderson, Todd Howlett, Jonathan Paterson, Ian Oudit, Gavin Y Kaul, Padma McAlister, Finlay A. Ezekowitz, Justin A. Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure |
title | Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure |
title_full | Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure |
title_fullStr | Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure |
title_full_unstemmed | Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure |
title_short | Change of Health‐Related Quality of Life Over Time and Its Association With Patient Outcomes in Patients With Heart Failure |
title_sort | change of health‐related quality of life over time and its association with patient outcomes in patients with heart failure |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660771/ https://www.ncbi.nlm.nih.gov/pubmed/32812460 http://dx.doi.org/10.1161/JAHA.120.017278 |
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