TY - JOUR
T1 - Factors associated with health-related quality of life in heart failure in 23,000 patients from 40 countries
T2 - results of the G-CHF research programme
AU - Johansson, Isabelle
AU - Balasubramanian, Kumar
AU - Bangdiwala, Shrikant
AU - Mielniczuk, Lisa
AU - Hage, Camilla
AU - Sharma, Sanjib Kumar
AU - Branch, Kelly
AU - Zhu, Jun
AU - Kragholm, Kristian
AU - Sliwa, Karen
AU - Alla, Francois
AU - Yonga, Gerald
AU - Roy, Ambuj
AU - Orlandini, Andres
AU - Grinvalds, Alex
AU - McCready, Tara
AU - Pogosova, Nana
AU - Störk, Stefan
AU - McMurray, John J. V.
AU - Conen, David
AU - Yusuf, Salim
AU - The GCHF investigators
N1 - © 2022 European Society of Cardiology.
PY - 2022/9
Y1 - 2022/9
N2 - Aims: To examine clinical and social correlates of health-related quality of life (HRQL) in patients with heart failure (HF) from high- (HIC), upper middle- (UMIC), lower middle- (LMIC) and low-income (LIC) countries. Methods and results: Between 2017 and 2020, 23 292 patients with HF (32% inpatients, 61% men) from 40 countries were enrolled in the Global Congestive Heart Failure study. HRQL was recorded at baseline using the Kansas City Cardiomyopathy Questionnaire (KCCQ)-12. In a cross-sectional analysis, we compared age- and sex-adjusted mean KCCQ-12 summary scores (SS: 0–100, higher = better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimated coefficients) of KCCQ-12-SS with sociodemographic, comorbidity, treatment and symptom covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. Mean age was 63 years and 40% of patients were in New York Heart Association (NYHA) class III–IV. Average HRQL was 55 SD 27. It was 62.5 (95% confidence interval [CI] 62.0–63.1) in HIC, 56.8 (56.1–57.4) in UMIC, 48.6 (48.0–49.3) in LMIC, and 38.5 (37.3–39.7) in LICs (p < 0.0001). Strong correlates (estimated coefficient [95% CI]) of KCCQ-12-SS were NYHA class III versus class I/II (−12.1 [−12.8 to −11.4] and class IV versus class I/II (−16.5 [−17.7 to −15.3]), effort dyspnoea (−9.5 [−10.2 to −8.8]) and living in LIC versus HIC (−5.8 [−7.1 to −4.4]). Symptoms explained most of the KCCQ-12-SS variability (partial R
2 = 0.32 of total adjusted R
2 = 0.51), followed by sociodemographic factors (R
2 = 0.12). Results were consistent in populations across income levels. Conclusion: The most important correlates of HRQL in HF patients relate to HF symptom severity, irrespective of country income level.
AB - Aims: To examine clinical and social correlates of health-related quality of life (HRQL) in patients with heart failure (HF) from high- (HIC), upper middle- (UMIC), lower middle- (LMIC) and low-income (LIC) countries. Methods and results: Between 2017 and 2020, 23 292 patients with HF (32% inpatients, 61% men) from 40 countries were enrolled in the Global Congestive Heart Failure study. HRQL was recorded at baseline using the Kansas City Cardiomyopathy Questionnaire (KCCQ)-12. In a cross-sectional analysis, we compared age- and sex-adjusted mean KCCQ-12 summary scores (SS: 0–100, higher = better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimated coefficients) of KCCQ-12-SS with sociodemographic, comorbidity, treatment and symptom covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. Mean age was 63 years and 40% of patients were in New York Heart Association (NYHA) class III–IV. Average HRQL was 55 SD 27. It was 62.5 (95% confidence interval [CI] 62.0–63.1) in HIC, 56.8 (56.1–57.4) in UMIC, 48.6 (48.0–49.3) in LMIC, and 38.5 (37.3–39.7) in LICs (p < 0.0001). Strong correlates (estimated coefficient [95% CI]) of KCCQ-12-SS were NYHA class III versus class I/II (−12.1 [−12.8 to −11.4] and class IV versus class I/II (−16.5 [−17.7 to −15.3]), effort dyspnoea (−9.5 [−10.2 to −8.8]) and living in LIC versus HIC (−5.8 [−7.1 to −4.4]). Symptoms explained most of the KCCQ-12-SS variability (partial R
2 = 0.32 of total adjusted R
2 = 0.51), followed by sociodemographic factors (R
2 = 0.12). Results were consistent in populations across income levels. Conclusion: The most important correlates of HRQL in HF patients relate to HF symptom severity, irrespective of country income level.
KW - Correlates
KW - Global
KW - Health status
KW - Heart failure
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=85131854578&partnerID=8YFLogxK
U2 - 10.1002/ejhf.2535
DO - 10.1002/ejhf.2535
M3 - Journal article
C2 - 35570198
SN - 1388-9842
VL - 24
SP - 1478
EP - 1490
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 9
ER -