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

TY - JOUR

T1 - Quality of life in men and women with heart failure

T2 - association with outcome, and comparison between the Kansas City Cardiomyopathy questionnaire and the EuroQol 5 dimensions questionnaire

AU - Ravera, Alice

AU - Santema, Bernadet T.

AU - Sama, Iziah E.

AU - Meyer, Sven

AU - Lombardi, Carlo M.

AU - Carubelli, Valentina

AU - Ferreira, João P.

AU - Lang, Chim C.

AU - Dickstein, Kenneth

AU - Anker, Stefan D.

AU - Samani, Nilesh J.

AU - Zannad, Faiez

AU - van Veldhuisen, Dirk J.

AU - Teerlink, John R.

AU - Metra, Marco

AU - Voors, Adriaan A.

N1 - This work was supported by a grant from the European Commission [FP7-242209-BIOSTATCHF].

PY - 2021/4

Y1 - 2021/4

N2 - 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 9 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 guideline-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 1 year compared to the EQ-5D scores (C-statistic 0.650 for KCCQ-OS vs. 0.633 and 0.599 for EQ-5D utility score and EQ-5D visual analogue scale, respectively). QoL was associated with all outcomes analysed, both in men and 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 women. The KCCQ in general, and the KCCQ-OS in particular, showed the strongest independent association with outcome.

AB - 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 9 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 guideline-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 1 year compared to the EQ-5D scores (C-statistic 0.650 for KCCQ-OS vs. 0.633 and 0.599 for EQ-5D utility score and EQ-5D visual analogue scale, respectively). QoL was associated with all outcomes analysed, both in men and 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 women. The KCCQ in general, and the KCCQ-OS in particular, showed the strongest independent association with outcome.

KW - Heart failure

KW - Outcome

KW - Quality of life

KW - Sex

KW - Women

UR - https://www.scopus.com/pages/publications/85104457980

U2 - 10.1002/ejhf.2154

DO - 10.1002/ejhf.2154

M3 - Article

C2 - 33728762

SN - 1388-9842

VL - 23

SP - 567

EP - 577

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

IS - 4

ER -