Health-related quality of life is an independent predictor of mortality and hospitalisations in transthyretin amyloid cardiomyopathy: a prospective cohort study.

IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Michael Poledniczek, Christina Kronberger, Robin Willixhofer, Nikita Ermolaev, Bernhard Cherouny, Theresa-Marie Dachs, René Rettl, Christina Binder-Rodriguez, Luciana Camuz Ligios, Bernhard Gregshammer, Andreas Anselm Kammerlander, Johannes Kastner, Jutta Bergler-Klein, Franz Duca, Roza Badr Eslam
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Abstract

Purpose: Transthyretin amyloid cardiomyopathy (ATTR-CM) is associated with severely impaired health-related quality of life (HRQL). HRQL is an independent predictor of outcome in heart failure (HF), but data on patients with ATTR-CM is scarce. This study therefore aims to evaluate the association of HRQL with outcome in ATTR-CM.

Methods: Patients from our prospective ATTR-CM registry were assessed using the Kansas City cardiomyopathy questionnaire (KCCQ), the Minnesota living with HF questionnaire (MLHFQ), and the EuroQol five dimensions questionnaire (EQ-5D). Cox regression analysis was utilised to assess the impact of HRQL on all-cause mortality.

Results: 167 patients [80 years; interquartile range (IQR): 76-84; 80.8% male] were followed for a median of 27.6 (IQR: 9.7-41.8) months. The primary endpoint of all-cause mortality was met by 43 (25.7%) patients after a median period of 16.2 (IQR: 9.1-28.1) months. In a univariate Cox regression for mortality, a 10-point change in the KCCQ implied a hazard ratio (HR) of 0.815 [95%-confidence interval (CI): 0.725-0.916; p = 0.001], in the EQ-5D VAS of 0.764 (95%-CI: 0.656-0.889; p < 0.001), and 1.163 (95%-CI: 1.114-1.433; p < 0.001) in the MLHFQ. After adjustment for established biomarkers of HF, all-cause mortality was predicted independently by the EQ-5D VAS (HR: 0.8; 95%-CI: 0.649-0.986; p = 0.037; per 10 points) and the MLHFQ (HR: 1.228; 95%-CI: 1.035-1.458; p = 0.019; per 10 points).

Conclusion: HRQL is a predictor of outcome in ATTR-CM. The EQ-5D VAS and the MLHFQ predict survival independent of biomarkers of HF.

Abstract Image

健康相关生活质量是转甲状腺素淀粉样变性心肌病死亡率和住院率的独立预测因素:一项前瞻性队列研究。
目的:转甲状腺素淀粉样变性心肌病(ATTR-CM)与健康相关生活质量(HRQL)严重受损有关。HRQL是心力衰竭(HF)预后的独立预测指标,但有关ATTR-CM患者的数据却很少。因此,本研究旨在评估HRQL与ATTR-CM预后的关系:方法:使用堪萨斯城心肌病问卷(KCCQ)、明尼苏达高频生活问卷(MLHFQ)和EuroQol五维问卷(EQ-5D)对我们的前瞻性ATTR-CM登记处的患者进行评估。采用 Cox 回归分析评估 HRQL 对全因死亡率的影响:167 名患者(80 岁;四分位数间距 (IQR):76-84;80.8% 为男性)接受了中位数为 27.6 个月(IQR:9.7-41.8)的随访。在中位数为 16.2(IQR:9.1-28.1)个月后,43 名患者(25.7%)达到了全因死亡率这一主要终点。在死亡率的单变量 Cox 回归中,KCCQ 的 10 分变化意味着危险比 (HR) 为 0.815 [95%-confidence interval (CI):0.725-0.916;p = 0.001],EQ-5D VAS 为 0.764 (95%-CI:0.656-0.889;p 结论:HRQL 是预测预后的重要指标:HRQL 是 ATTR-CM 预后的预测因子。EQ-5D VAS 和 MLHFQ 可以预测生存率,而不受 HF 生物标志物的影响。
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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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