An increasing number of comorbidities (≥4 vs 0) was associated with decreasing KCCQ overall summary scores in both HFrEF (66.4 vs 76.8) and HFpEF (65.2 vs 73.7) patients.
Observational (n=26,722)
Yes
Does the presence and number of comorbidities reduce health status measured by KCCQ in patients with HFrEF and HFpEF?
Cardiac and non-cardiac comorbidities are highly prevalent in both HFrEF and HFpEF and are associated with significant, cumulative reductions in patient-reported health status.
AIM: Patients with heart failure (HF) often suffer from a range of comorbidities, which may affect their health status. The aim of this study was to assess the impact of different comorbidities on health status in patients with HF and reduced (HFrEF) and preserved ejection fraction (HFpEF). METHODS AND RESULTS: Using individual patient data from HFrEF (ATMOSPHERE, PARADIGM-HF, DAPA-HF) and HFpEF (TOPCAT, PARAGON-HF) trials, we examined the Kansas City Cardiomyopathy Questionnaire (KCCQ) domain scores and overall summary score (KCCQ-OSS) across a range of cardiorespiratory (angina, atrial fibrillation AF, stroke, chronic obstructive pulmonary disease COPD) and other comorbidities (obesity, diabetes, chronic kidney disease CKD, anaemia). Of patients with HFrEF (n = 20 159), 36.2% had AF, 33.9% CKD, 33.9% diabetes, 31.4% obesity, 25.5% angina, 12.2% COPD, 8.4% stroke, and 4.4% anaemia; the corresponding proportions in HFpEF (n = 6563) were: 54.0% AF, 48.7% CKD, 43.4% diabetes, 53.3% obesity, 28.6% angina, 14.7% COPD, 10.2% stroke, and 6.5% anaemia. HFpEF patients had lower KCCQ domain scores and KCCQ-OSS (67.8 vs. 71.3) than HFrEF patients. Physical limitations, social limitations and quality of life domains were reduced more than symptom frequency and symptom burden domains. In both HFrEF and HFpEF, COPD, angina, anaemia, and obesity were associated with the lowest scores. An increasing number of comorbidities was associated with decreasing scores (e.g. KCCQ-OSS 0 vs. ≥4 comorbidities: HFrEF 76.8 vs. 66.4; HFpEF 73.7 vs. 65.2). CONCLUSIONS: Cardiac and non-cardiac comorbidities are common in both HFrEF and HFpEF patients and most are associated with reductions in health status although the impact varied among comorbidities, by the number of comorbidities, and by HF phenotype. Treating/correcting comorbidity is a therapeutic approach that may improve the health status of patients with HF.
Yang et al. (Tue,) conducted a observational in Heart failure with reduced and preserved ejection fraction (n=26,722). Comorbidities vs. Fewer or no comorbidities was evaluated on Kansas City Cardiomyopathy Questionnaire (KCCQ) domain scores and overall summary score (KCCQ-OSS). An increasing number of comorbidities (≥4 vs 0) was associated with decreasing KCCQ overall summary scores in both HFrEF (66.4 vs 76.8) and HFpEF (65.2 vs 73.7) patients.