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. 2022 Sep;24(9):1478-1490.
doi: 10.1002/ejhf.2535. Epub 2022 Jun 15.

Factors associated with health-related quality of life in heart failure in 23 000 patients from 40 countries: results of the G-CHF research programme

Isabelle Johansson  1   2 , Kumar Balasubramanian  1 , Shrikant Bangdiwala  1   2 , Lisa Mielniczuk  3 , Camilla Hage  4   5 , Sanjib Kumar Sharma  6 , Kelley Branch  7 , Jun Zhu  8 , Kristian Kragholm  9 , Karen Sliwa  10 , Francois Alla  11   12 , Gerald Yonga  13 , Ambuj Roy  14 , Andres Orlandini  15 , Alex Grinvalds  1 , Tara McCready  1 , Nana Pogosova  16 , Stefan Störk  17 , John J V McMurray  18 , David Conen  1   2 , Salim Yusuf  1   2
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Free article

Factors associated with health-related quality of life in heart failure in 23 000 patients from 40 countries: results of the G-CHF research programme

Isabelle Johansson et al. Eur J Heart Fail. 2022 Sep.
Free article

Abstract

Aims: To examine clinical and social correlates of health-related quality of life (HRQL) in patients with heart failure (HF) from high- (HIC), upper middle- (UMIC), lower middle- (LMIC) and low-income (LIC) countries.

Methods and results: Between 2017 and 2020, 23 292 patients with HF (32% inpatients, 61% men) from 40 countries were enrolled in the Global Congestive Heart Failure study. HRQL was recorded at baseline using the Kansas City Cardiomyopathy Questionnaire (KCCQ)-12. In a cross-sectional analysis, we compared age- and sex-adjusted mean KCCQ-12 summary scores (SS: 0-100, higher = better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimated coefficients) of KCCQ-12-SS with sociodemographic, comorbidity, treatment and symptom covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. Mean age was 63 years and 40% of patients were in New York Heart Association (NYHA) class III-IV. Average HRQL was 55 SD 27. It was 62.5 (95% confidence interval [CI] 62.0-63.1) in HIC, 56.8 (56.1-57.4) in UMIC, 48.6 (48.0-49.3) in LMIC, and 38.5 (37.3-39.7) in LICs (p < 0.0001). Strong correlates (estimated coefficient [95% CI]) of KCCQ-12-SS were NYHA class III versus class I/II (-12.1 [-12.8 to -11.4] and class IV versus class I/II (-16.5 [-17.7 to -15.3]), effort dyspnoea (-9.5 [-10.2 to -8.8]) and living in LIC versus HIC (-5.8 [-7.1 to -4.4]). Symptoms explained most of the KCCQ-12-SS variability (partial R2 = 0.32 of total adjusted R2 = 0.51), followed by sociodemographic factors (R2 = 0.12). Results were consistent in populations across income levels.

Conclusion: The most important correlates of HRQL in HF patients relate to HF symptom severity, irrespective of country income level.

Keywords: Correlates; Global; Health status; Heart failure; Quality of life.

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References

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