Quality of life and the associated risk of all-cause mortality in nonischemic heart failure

Johan S Bundgaard; Jens J Thune; Gunnar Gislason; Emil L Fosbøl; Christian Torp-Pedersen; David Aagaard; Jens C Nielsen; Jens Haarbo; Anna M Thøgersen; Lars Videbæk; Gunnar Jensen; Line L Olesen; Søren L Kristensen; Susanne S Pedersen; Lars Køber; Ulrik M Mogensen

doi:10.1016/j.ijcard.2020.02.008

Quality of life and the associated risk of all-cause mortality in nonischemic heart failure

Johan S Bundgaard, Jens J Thune, Gunnar Gislason, Emil L Fosbøl, Christian Torp-Pedersen, David Aagaard, Jens C Nielsen, Jens Haarbo, Anna M Thøgersen, Lars Videbæk, Gunnar Jensen, Line L Olesen, Søren L Kristensen, Susanne S Pedersen, Lars Køber, Ulrik M Mogensen

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

OBJECTIVES: To examine the association between health-related quality of life (HRQoL) and mortality in patients with heart failure (HF).

BACKGROUND: The potential association of HRQoL and mortality in patients with HF is unclear. We investigated this association in The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators (ICD) in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH).

METHODS: In DANISH, a total of 1116 patients with non-ischemic systolic HF on guideline-recommended therapy were randomized to ICD therapy or usual clinical care. HRQoL was assessed at randomization using the disease-specific Minnesota Living with Heart Failure Questionnaire (MLHFQ, 0-105, high score indicating worse HRQoL). Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) for all-cause mortality according to MLHFQ above or below 45, as recommended by a recent meta-analysis, to identify patients with poor HRQoL.

RESULTS: HRQoL was completed by 935 (84%) patients at baseline with a median follow-up of 67 months (IQR 47-83). Patients with poor HRQoL (MLHFQ score > 45, median 60 (IQR 53-71),n = 350) had a higher incidence of all-cause mortality than patients with moderate/good HRQoL (MLHFQ ≤45, median 23 (IQR 13-33), n = 585), respectively 26% vs. 18% with an unadjusted HR of 1.57 (95% CI 1.19-2.08, p = .002), and an adjusted HR of 1.39 (95% CI 1.01-1.91, p = .04).

CONCLUSION: Poor HRQoL was associated with an increased risk of all-cause mortality after adjustment for traditional risk factors.

CLINICAL TRIAL REGISTRATION: https: //clinicaltrials.gov/ct2/show/NCT00542945(DANISH).

Original language	English
Journal	International Journal of Cardiology
Volume	305
Pages (from-to)	92-98
Number of pages	7
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2020.02.008
Publication status	Published - 15 Apr 2020

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Bundgaard, J. S., Thune, J. J., Gislason, G., Fosbøl, E. L., Torp-Pedersen, C., Aagaard, D., Nielsen, J. C., Haarbo, J., Thøgersen, A. M., Videbæk, L., Jensen, G., Olesen, L. L., Kristensen, S. L., Pedersen, S. S., Køber, L., & Mogensen, U. M. (2020). Quality of life and the associated risk of all-cause mortality in nonischemic heart failure. International Journal of Cardiology, 305, 92-98. https://doi.org/10.1016/j.ijcard.2020.02.008

@article{0204e51b07014ec8b48548d0465866bd,

title = "Quality of life and the associated risk of all-cause mortality in nonischemic heart failure",

abstract = "OBJECTIVES: To examine the association between health-related quality of life (HRQoL) and mortality in patients with heart failure (HF).BACKGROUND: The potential association of HRQoL and mortality in patients with HF is unclear. We investigated this association in The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators (ICD) in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH).METHODS: In DANISH, a total of 1116 patients with non-ischemic systolic HF on guideline-recommended therapy were randomized to ICD therapy or usual clinical care. HRQoL was assessed at randomization using the disease-specific Minnesota Living with Heart Failure Questionnaire (MLHFQ, 0-105, high score indicating worse HRQoL). Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) for all-cause mortality according to MLHFQ above or below 45, as recommended by a recent meta-analysis, to identify patients with poor HRQoL.RESULTS: HRQoL was completed by 935 (84%) patients at baseline with a median follow-up of 67 months (IQR 47-83). Patients with poor HRQoL (MLHFQ score > 45, median 60 (IQR 53-71),n = 350) had a higher incidence of all-cause mortality than patients with moderate/good HRQoL (MLHFQ ≤45, median 23 (IQR 13-33), n = 585), respectively 26% vs. 18% with an unadjusted HR of 1.57 (95% CI 1.19-2.08, p = .002), and an adjusted HR of 1.39 (95% CI 1.01-1.91, p = .04).CONCLUSION: Poor HRQoL was associated with an increased risk of all-cause mortality after adjustment for traditional risk factors.CLINICAL TRIAL REGISTRATION: https: //clinicaltrials.gov/ct2/show/NCT00542945(DANISH).",

author = "Bundgaard, {Johan S} and Thune, {Jens J} and Gunnar Gislason and Fosb{\o}l, {Emil L} and Christian Torp-Pedersen and David Aagaard and Nielsen, {Jens C} and Jens Haarbo and Th{\o}gersen, {Anna M} and Lars Videb{\ae}k and Gunnar Jensen and Olesen, {Line L} and Kristensen, {S{\o}ren L} and Pedersen, {Susanne S} and Lars K{\o}ber and Mogensen, {Ulrik M}",

year = "2020",

month = apr,

day = "15",

doi = "10.1016/j.ijcard.2020.02.008",

language = "English",

volume = "305",

pages = "92--98",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier",

}

Bundgaard, JS, Thune, JJ, Gislason, G, Fosbøl, EL, Torp-Pedersen, C, Aagaard, D, Nielsen, JC, Haarbo, J, Thøgersen, AM, Videbæk, L, Jensen, G, Olesen, LL, Kristensen, SL, Pedersen, SS, Køber, L & Mogensen, UM 2020, 'Quality of life and the associated risk of all-cause mortality in nonischemic heart failure', International Journal of Cardiology, vol. 305, pp. 92-98. https://doi.org/10.1016/j.ijcard.2020.02.008

TY - JOUR

T1 - Quality of life and the associated risk of all-cause mortality in nonischemic heart failure

AU - Bundgaard, Johan S

AU - Thune, Jens J

AU - Gislason, Gunnar

AU - Fosbøl, Emil L

AU - Torp-Pedersen, Christian

AU - Aagaard, David

AU - Nielsen, Jens C

AU - Haarbo, Jens

AU - Thøgersen, Anna M

AU - Videbæk, Lars

AU - Jensen, Gunnar

AU - Olesen, Line L

AU - Kristensen, Søren L

AU - Pedersen, Susanne S

AU - Køber, Lars

AU - Mogensen, Ulrik M

PY - 2020/4/15

Y1 - 2020/4/15

N2 - OBJECTIVES: To examine the association between health-related quality of life (HRQoL) and mortality in patients with heart failure (HF).BACKGROUND: The potential association of HRQoL and mortality in patients with HF is unclear. We investigated this association in The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators (ICD) in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH).METHODS: In DANISH, a total of 1116 patients with non-ischemic systolic HF on guideline-recommended therapy were randomized to ICD therapy or usual clinical care. HRQoL was assessed at randomization using the disease-specific Minnesota Living with Heart Failure Questionnaire (MLHFQ, 0-105, high score indicating worse HRQoL). Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) for all-cause mortality according to MLHFQ above or below 45, as recommended by a recent meta-analysis, to identify patients with poor HRQoL.RESULTS: HRQoL was completed by 935 (84%) patients at baseline with a median follow-up of 67 months (IQR 47-83). Patients with poor HRQoL (MLHFQ score > 45, median 60 (IQR 53-71),n = 350) had a higher incidence of all-cause mortality than patients with moderate/good HRQoL (MLHFQ ≤45, median 23 (IQR 13-33), n = 585), respectively 26% vs. 18% with an unadjusted HR of 1.57 (95% CI 1.19-2.08, p = .002), and an adjusted HR of 1.39 (95% CI 1.01-1.91, p = .04).CONCLUSION: Poor HRQoL was associated with an increased risk of all-cause mortality after adjustment for traditional risk factors.CLINICAL TRIAL REGISTRATION: https: //clinicaltrials.gov/ct2/show/NCT00542945(DANISH).

AB - OBJECTIVES: To examine the association between health-related quality of life (HRQoL) and mortality in patients with heart failure (HF).BACKGROUND: The potential association of HRQoL and mortality in patients with HF is unclear. We investigated this association in The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators (ICD) in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH).METHODS: In DANISH, a total of 1116 patients with non-ischemic systolic HF on guideline-recommended therapy were randomized to ICD therapy or usual clinical care. HRQoL was assessed at randomization using the disease-specific Minnesota Living with Heart Failure Questionnaire (MLHFQ, 0-105, high score indicating worse HRQoL). Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) for all-cause mortality according to MLHFQ above or below 45, as recommended by a recent meta-analysis, to identify patients with poor HRQoL.RESULTS: HRQoL was completed by 935 (84%) patients at baseline with a median follow-up of 67 months (IQR 47-83). Patients with poor HRQoL (MLHFQ score > 45, median 60 (IQR 53-71),n = 350) had a higher incidence of all-cause mortality than patients with moderate/good HRQoL (MLHFQ ≤45, median 23 (IQR 13-33), n = 585), respectively 26% vs. 18% with an unadjusted HR of 1.57 (95% CI 1.19-2.08, p = .002), and an adjusted HR of 1.39 (95% CI 1.01-1.91, p = .04).CONCLUSION: Poor HRQoL was associated with an increased risk of all-cause mortality after adjustment for traditional risk factors.CLINICAL TRIAL REGISTRATION: https: //clinicaltrials.gov/ct2/show/NCT00542945(DANISH).

U2 - 10.1016/j.ijcard.2020.02.008

DO - 10.1016/j.ijcard.2020.02.008

M3 - Journal article

C2 - 32046910

SN - 0167-5273

VL - 305

SP - 92

EP - 98

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Quality of life and the associated risk of all-cause mortality in nonischemic heart failure

Abstract

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