Loss of quality of life and increased societal costs in patients with hypertrophic cardiomyopathy: the AFFECT-HCM study.

IF 4.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal - Quality of Care and Clinical Outcomes Pub Date : 2025-03-03 DOI:10.1093/ehjqcco/qcae092

Stephan A C Schoonvelde, Isabell Wiethoff, Peter-Paul Zwetsloot, Alexander Hirsch, Christian Knackstedt, Tjeerd Germans, Maurits Sikking, Arend F L Schinkel, Marjon A van Slegtenhorst, Judith M A Verhagen, Rudolf A de Boer, Silvia M A A Evers, Mickaël Hiligsmann, Michelle Michels

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引用次数: 0

Abstract

Introduction: Hypertrophic cardiomyopathy (HCM) is the most prevalent inherited cardiac disease. The impact of HCM on quality of life (QoL) and societal costs remains poorly understood. This prospective multi-centre burden of disease study estimated QoL and societal costs of genotyped HCM patients and genotype-positive phenotype-negative (G+/P-) subjects.

Methods and results: Participants were categorized into three groups based on genotype and phenotype: (i) G+/P- [left ventricular (LV) wall thickness <13 mm], (ii) non-obstructive HCM [nHCM, LV outflow tract (LVOT) gradient <30 mmHg], and (iii) obstructive HCM (oHCM, LVOT gradient ≥30 mmHg). We assessed QoL with EQ-5D-5L and Kansas City Cardiomyopathy Questionnaires (KCCQ). Societal costs were measured using medical consumption (Medical Consumption Questionnaire) and productivity cost (iMTA Productivity Cost Questionnaire) questionnaires. We performed subanalyses within three age groups: <40, 40-59, and ≥60 years. From three Dutch hospitals, 506 subjects were enrolled (84 G+/P-, 313 nHCM, 109 oHCM; median age 59 years, 39% female). HCM (both nHCM and oHCM) patients reported reduced QoL vs. G+/P- subjects (KCCQ: 88 vs. 98, EQ-5D-5L: 0.88 vs. 0.96; both P < 0.001). oHCM patients reported lower KCCQ scores than nHCM patients (83 vs. 89, P = 0.036). Societal costs were significantly higher in HCM patients (€19,035/year vs. €7385/year) compared with G+/P- controls, mainly explained by higher healthcare costs and productivity losses. Being symptomatic and of younger age (<60 years) particularly led to decreased QoL and increased costs.

Conclusion: HCM is associated with decreased QoL and increased societal costs, especially in younger and symptomatic patients. oHCM patients were more frequently symptomatic than nHCM patients. This study highlights the substantial disease burden of HCM and can aid in assessing new therapy cost-effectiveness for HCM in the future.

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肥厚型心肌病患者生活质量下降和社会成本增加：AFFECT-HCM 研究。

导言肥厚型心肌病（HCM）是最普遍的遗传性心脏病。人们对肥厚性心肌病对生活质量（QoL）和社会成本的影响仍知之甚少。这项前瞻性多中心疾病负担研究估算了基因分型 HCM 患者和基因型阳性表型阴性（G+/P-）受试者的 QoL 和社会成本：根据基因型和表型将参与者分为三组：1）G+/P-（左心室壁厚度荷兰三家医院共招募了 506 名受试者（84 名 G+/P-、313 名 nHCM、109 名 oHCM；中位年龄 59 岁，39% 为女性）。与 G+/P- 受试者相比，HCM（包括 nHCM 和 oHCM）患者的 QoL 有所下降（KCCQ：88 vs 98，EQ-5D-5L：0.88 vs 0.96；p 均为 0）：oHCM 患者比 nHCM 患者更常出现症状。这项研究强调了 HCM 带来的巨大疾病负担，有助于将来评估 HCM 新疗法的成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal - Quality of Care and Clinical Outcomes CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

3.80%

发文量

期刊介绍： European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.