TY - JOUR
T1 - Multinational and multiethnic variations in health-related quality of life in patients with chronic heart failure
AU - ASIAN-HF
AU - HF-ACTION investigators
AU - Luo, Nancy
AU - Anand, Inder
AU - Tay, Wan Ting
AU - Kraus, William E.
AU - Liew, Houng Bang
AU - Ling, Lieng Hsi
AU - O'Connor, Christopher M.
AU - Piña, Ileana L.
AU - Richards, A. Mark
AU - Shimizu, Wataru
AU - Whellan, David J.
AU - Yap, Jonathan
AU - Lam, Carolyn S.P.
AU - Mentz, Robert J.
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/9
Y1 - 2017/9
N2 - Background: Assessing health-related quality of life (HRQoL) in patients with heart failure (HF) is an important goal of clinical care and HF research. We sought to investigate ethnic differences in perceived HRQoL and its association with mortality among patients with HF and left ventricular ejection fraction ≤35%, controlling for demographic characteristics and HF severity. Methods and results: We compared 5697 chronic HF patients of Indian (26%), white (23%), Chinese (17%), Japanese/Koreans (12%), black (12%), and Malay (10%) ethnicities from the HF-ACTION and ASIAN-HF multinational studies using the Kansas City Cardiomyopathy Questionnaire (KCCQ; range 0-100; higher scores reflect better health status). KCCQ scores were lowest in Malay (58 ± 22) and Chinese (60 ± 23), intermediate in black (64 ± 21) and Indian (65 ± 23), and highest in white (67 ± 20) and Japanese or Korean patients (67 ± 22) after adjusting for age, sex, educational status, HF severity, and risk factors. Self-efficacy, which measures confidence in the ability to manage symptoms, was lower in all Asian ethnicities (especially Japanese/Koreans [60 ± 26], Malay [66 ± 23], and Chinese [64 ± 28]) compared to black (80 ± 21) and white (82 ± 19) patients, even after multivariable adjustment (P <.001). In all ethnicities, KCCQ strongly predicted 1-year mortality (HR 0.45, 95% CI 0.30-0.67 for highest vs lowest quintile of KCCQ; P for interaction by ethnicity.101). Conclusions: Overall, HRQoL is inversely and independently related to mortality in chronic HF but is not modified by ethnicity. Nevertheless, ethnic differences exist independent of HF severity and comorbidities. These data may have important implications for future global clinical HF trials that use patient-reported outcomes as endpoints.
AB - Background: Assessing health-related quality of life (HRQoL) in patients with heart failure (HF) is an important goal of clinical care and HF research. We sought to investigate ethnic differences in perceived HRQoL and its association with mortality among patients with HF and left ventricular ejection fraction ≤35%, controlling for demographic characteristics and HF severity. Methods and results: We compared 5697 chronic HF patients of Indian (26%), white (23%), Chinese (17%), Japanese/Koreans (12%), black (12%), and Malay (10%) ethnicities from the HF-ACTION and ASIAN-HF multinational studies using the Kansas City Cardiomyopathy Questionnaire (KCCQ; range 0-100; higher scores reflect better health status). KCCQ scores were lowest in Malay (58 ± 22) and Chinese (60 ± 23), intermediate in black (64 ± 21) and Indian (65 ± 23), and highest in white (67 ± 20) and Japanese or Korean patients (67 ± 22) after adjusting for age, sex, educational status, HF severity, and risk factors. Self-efficacy, which measures confidence in the ability to manage symptoms, was lower in all Asian ethnicities (especially Japanese/Koreans [60 ± 26], Malay [66 ± 23], and Chinese [64 ± 28]) compared to black (80 ± 21) and white (82 ± 19) patients, even after multivariable adjustment (P <.001). In all ethnicities, KCCQ strongly predicted 1-year mortality (HR 0.45, 95% CI 0.30-0.67 for highest vs lowest quintile of KCCQ; P for interaction by ethnicity.101). Conclusions: Overall, HRQoL is inversely and independently related to mortality in chronic HF but is not modified by ethnicity. Nevertheless, ethnic differences exist independent of HF severity and comorbidities. These data may have important implications for future global clinical HF trials that use patient-reported outcomes as endpoints.
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U2 - 10.1016/j.ahj.2017.06.016
DO - 10.1016/j.ahj.2017.06.016
M3 - Article
C2 - 28888273
AN - SCOPUS:85026550156
SN - 0002-8703
VL - 191
SP - 75
EP - 81
JO - American Heart Journal
JF - American Heart Journal
ER -