Key result
Women with HFrEF reported worse baseline quality of life than men, but higher KCCQ overall scores were independently associated with a lower risk of all-cause mortality in both sexes (HR 0.95).
Why the study?
The authors sought to analyze quality of life measures derived from the KCCQ and EQ-5D questionnaires and compare their prognostic value in men and women with HFrEF.
Does quality of life measured by KCCQ and EQ-5D differ between men and women with HFrEF, and how do these measures associate with mortality?
Observational (n=1,649)
Yes
Does quality of life measured by KCCQ and EQ-5D differ between men and women with HFrEF, and how do these measures associate with mortality?
In patients with HFrEF, women report worse baseline quality of life than men, and the KCCQ overall score is a stronger predictor of 1-year mortality than the EQ-5D.
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.
No takes yet. Share an insight, caveat, or question.
Ravera et al. (2021) conducted an observational in Heart failure with reduced ejection fraction (HFrEF) (n=1,649). Kansas City Cardiomyopathy Questionnaire (KCCQ) overall score was evaluated on All-cause mortality per 5-point increase in KCCQ overall score (adjusted) (HR 0.95, 95% CI 0.92-0.97, p=<0.001). Women with HFrEF reported worse baseline quality of life than men, but higher KCCQ overall scores were independently associated with a lower risk of all-cause mortality in both sexes (HR 0.95).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: