Quality of life in men and women with heart failure: association with outcome, and comparison of the Kansas City Cardiomyopathy Questionnaire and the EuroQol 5 dimensions questionnaire

Alice Ravera, Bernadet T. Santema, Iziah E. Sama, Sven Meyer, Carlo M. Lombardi, Valentina Carubelli, João P. Ferreira, Chim C. Lang, Kenneth Dickstein, Stefan D. Anker, Nilesh J. Samani, Faiez Zannad, Dirk J. van Veldhuisen, John R. Teerlink, Marco Metra (Lead / Corresponding author), Adriaan A. Voors

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: We sought to analyse quality of life (QoL) measures derived from two questionnaires widely used in clinical trials, the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQoL 5 dimensions (EQ-5D), and to compare their prognostic value in men and women with heart failure and reduced ejection fraction (HFrEF).

Methods and Results: From the BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) we compared KCCQ and EQ-5D at baseline and after nine months in 1276 men and 373 women with new-onset or worsening symptoms of HFrEF, who were sub-optimally treated and in whom there was an anticipated up-titration of guidelines-derived medical therapies. Women had significantly worse baseline QoL (median) as compared with men, both when assessed with KCCQ overall score (KCCQ-OS, 44 vs 53, p<0.001) and EQ-5D utility score (0.62 vs 0.73, p<0.001). QoL improved equally in women and men at follow-up. All summary measures of QoL were independently associated with all-cause mortality, with KCCQ-OS showing the most remarkable association with mortality up to one year compared to the EQ-5D scores (C-statistic 0.650 for KCCQ-OS vs 0.633 and 0.599 for EQ-5D US and EQ-5D VAS respectively). QoL was associated with all outcomes analysed, both in men and in women (all p for interaction with sex >0.2).

Conclusion: Amongst patients with HFrEF, women reported significantly worse QoL than men. QoL was independently associated with subsequent outcome, similarly in men and in women. The KCCQ in general, and KCCQ-OS in particular, showed the strongest independent association with outcome.

Original languageEnglish
JournalEuropean Journal of Heart Failure
Early online date16 Mar 2021
DOIs
Publication statusE-pub ahead of print - 16 Mar 2021

Keywords

  • Heart failure
  • Quality of life
  • Sex
  • Women
  • Outcome

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