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Health-related quality of life and mortality in heart failure. The global congestive heart failure study of 23000 patients from 40 countries

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dc.contributor.authorJohansson, Isabelle
dc.contributor.authorJoseph, Philip
dc.contributor.authorBalasubramanian, Kumar
dc.contributor.authorMcMurray, John J.V.
dc.contributor.authorLund, Lars H.
dc.contributor.authorEzekowitz, Justin A.
dc.contributor.authorKamath, Deepak
dc.contributor.authorAlhabib, Khalid
dc.contributor.authorBayes-Genis, Antoni
dc.contributor.authorBudaj, Andrzej
dc.contributor.authorDans, Antonio
dc.contributor.authorDzudie, Anastase
dc.contributor.authorProbstfield, Jefferey L.
dc.contributor.authorFox, Keith A.
dc.contributor.authorKaraye, Kamilu M.
dc.contributor.authorMakubi, Abel
dc.contributor.authorFukakusa, Bianca
dc.contributor.authorTeo, Koon
dc.contributor.authorTemizhan, Ahmet
dc.contributor.authorWittlinger, Thomas
dc.contributor.authorMaggioni, Aldo P.
dc.contributor.authorLanas, Fernando
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorSilva-Cardoso, José
dc.contributor.authorSliwa, Karen
dc.contributor.authorDokainish, Hisham
dc.contributor.authorGrinvalds, Alex
dc.contributor.authorMcCready, Tara
dc.contributor.authorYusuf, Salim
dc.contributor.authorG-CHF Investigators
dc.contributor.researchgroupMasiraspa
dc.date.accessioned2022-02-18T14:34:04Z
dc.date.available2022-02-18T14:34:04Z
dc.date.issued2021-04-28
dc.descriptionDigitalspa
dc.description.abstractBackground: Poor health-related quality of life (HRQL) is common in heart failure (HF), but there are few data on HRQL in HF and the association between HRQL and mortality outside Western countries. Methods: We used the Kansas City Cardiomyopathy Questionnaire–12 (KCCQ-12) to record HRQL in 23 291 patients with HF from 40 countries in 8 different world regions in the G-CHF study (Global Congestive Heart Failure). We compared standardized KCCQ-12 summary scores (adjusted for age, sex, and markers of HF severity) among regions (scores range from 0 to 100, with higher score indicating better HRQL). We used multivariable Cox regression with adjustment for 15 variables to assess the association between KCCQ-12 summary scores and the composite of all-cause death, HF hospitalization, and each component over a median follow-up of 1.6 years. Results: The mean age of participants was 65 years; 61% were men; 40% had New York Heart Association class III or IV symptoms; and 46% had left ventricular ejection fraction ≥40%. Average HRQL differed between regions (lowest in Africa [mean± SE, 39.5±0.3], highest in Western Europe [62.5±0.4]). There were 4460 (19%) deaths, 3885 (17%) HF hospitalizations, and 6949 (30%) instances of either event. Lower KCCQ-12 summary score was associated with higher risk of all outcomes; the adjusted hazard ratio (HR) for each 10-unit KCCQ-12 summary score decrement was 1.18 (95% CI, 1.17–1.20) for death. Although this association was observed in all regions, it was less marked in South Asia, South America, and Africa (weakest association in South Asia: HR, 1.08 [95% CI, 1.03–1.14]; strongest association in Eastern Europe: HR, 1.31 [95% CI, 1.21–1.42]; interaction P<0.0001). Lower HRQL predicted death in patients with New York Heart Association class I or II and III or IV symptoms (HR, 1.17 [95% CI, 1.14–1.19] and HR, 1.14 [95% CI, 1.12–1.17]; interaction P=0.13) and was a stronger predictor for the composite outcome in New York Heart Association class I or II versus class III or IV (HR 1.15 [95% CI, 1.13–1.17] versus 1.09 [95% CI, [1.07–1.11]; interaction P<0.0001). HR for death was greater in ejection fraction ≥40 versus <40% (HR, 1.23 [95% CI, 1.20–1.26] and HR, 1.15 [95% CI, 1.13–1.17]; interaction P<0.0001). Conclusion: HRQL is a strong and independent predictor of all-cause death and HF hospitalization across all geographic regions, in mildly and severe symptomatic HF, and among patients with preserved and reduced ejection fraction.spa
dc.description.researchareaCiencias Medicas y de la Saludspa
dc.format.extent14 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.1161/CIRCULATIONAHA.120.050850
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6046
dc.language.isoengspa
dc.publisherAmerican Heart Association, Inc.spa
dc.publisher.placeUSAspa
dc.relation.citationendpage1242spa
dc.relation.citationissue22spa
dc.relation.citationstartpage2129spa
dc.relation.citationvolume143spa
dc.relation.indexedScopusspa
dc.relation.ispartofjournalCirculationspa
dc.rights© 2021 American Heart Association, Inc.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.050850spa
dc.titleHealth-related quality of life and mortality in heart failure. The global congestive heart failure study of 23000 patients from 40 countriesspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2spa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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