Changes in health-related quality of life and treatment effects in chronic heart failure : a meta-analysis
Copyright © 2023 Elsevier B.V. All rights reserved..
BACKGROUND: Heart failure (HF) is associated with poor health status, and high morbi-mortality. However, it is not well established how health status changes correlate with treatment effects on clinical outcomes. Our aim was to study the association between treatment-induced changes in health-status, assessed by Kansas City Cardiomyopathy Questionnaire 23 (KCCQ-23), and clinical outcomes in chronic HF.
METHODS: Systematic search of phase III-IV pharmacological RCTs in chronic HF that assessed KCCQ-23 changes and clinical outcomes throughout follow-up. We studied the association between treatment induced changes in KCCQ-23 and treatment effects on clinical outcomes (HF hospitalization or cardiovascular death, HF hospitalization, cardiovascular death, and all-cause death) using weighted random-effects meta-regression.
RESULTS: Sixteen trials were included, enrolling a total of 65,608 participants. Treatment induced KCCQ-23 changes were moderately correlated with treatment effects on the combined outcome of HF hospitalization or cardiovascular mortality (regression coefficient (RC) = -0.047, 95%CI: -0.085 to -0.009; R2 = 49%), a correlation that was mainly driven by HF hospitalization (RC = -0.076, 95%CI: -0.124 to -0.029; R2 = 56%). Correlations of treatment induced KCCQ-23 changes with cardiovascular death (RC = -0.029, 95%CI: -0.073 to 0.015; R2 = 10%) and all-cause death (RC = -0.019, 95%CI: -0.057 to 0.019; R2 = 0%) were weak and non-significant.
CONCLUSIONS: Treatment-induced changes in KCCQ-23 were moderately correlated with treatment-effects on HF hospitalizations but were not correlated with the effects on cardiovascular and all-cause mortality. Treatment-induced changes in patient-centered outcomes (i.e., KCCQ-23) may reflect non-fatal symptomatic changes in the clinical course of HF leading to hospitalization.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:386 |
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| Enthalten in: |
International journal of cardiology - 386(2023) vom: 01. Sept., Seite 65-73 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Angélico-Gonçalves, António [VerfasserIn] |
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| Links: |
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| Themen: |
Health status |
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| Anmerkungen: |
Date Completed 15.06.2023 Date Revised 26.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2023.05.032 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357135466 |
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| 100 | 1 | |a Angélico-Gonçalves, António |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Changes in health-related quality of life and treatment effects in chronic heart failure |b a meta-analysis |
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| 500 | |a Date Completed 15.06.2023 | ||
| 500 | |a Date Revised 26.06.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Heart failure (HF) is associated with poor health status, and high morbi-mortality. However, it is not well established how health status changes correlate with treatment effects on clinical outcomes. Our aim was to study the association between treatment-induced changes in health-status, assessed by Kansas City Cardiomyopathy Questionnaire 23 (KCCQ-23), and clinical outcomes in chronic HF | ||
| 520 | |a METHODS: Systematic search of phase III-IV pharmacological RCTs in chronic HF that assessed KCCQ-23 changes and clinical outcomes throughout follow-up. We studied the association between treatment induced changes in KCCQ-23 and treatment effects on clinical outcomes (HF hospitalization or cardiovascular death, HF hospitalization, cardiovascular death, and all-cause death) using weighted random-effects meta-regression | ||
| 520 | |a RESULTS: Sixteen trials were included, enrolling a total of 65,608 participants. Treatment induced KCCQ-23 changes were moderately correlated with treatment effects on the combined outcome of HF hospitalization or cardiovascular mortality (regression coefficient (RC) = -0.047, 95%CI: -0.085 to -0.009; R2 = 49%), a correlation that was mainly driven by HF hospitalization (RC = -0.076, 95%CI: -0.124 to -0.029; R2 = 56%). Correlations of treatment induced KCCQ-23 changes with cardiovascular death (RC = -0.029, 95%CI: -0.073 to 0.015; R2 = 10%) and all-cause death (RC = -0.019, 95%CI: -0.057 to 0.019; R2 = 0%) were weak and non-significant | ||
| 520 | |a CONCLUSIONS: Treatment-induced changes in KCCQ-23 were moderately correlated with treatment-effects on HF hospitalizations but were not correlated with the effects on cardiovascular and all-cause mortality. Treatment-induced changes in patient-centered outcomes (i.e., KCCQ-23) may reflect non-fatal symptomatic changes in the clinical course of HF leading to hospitalization | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Health status | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Hospitalization | |
| 650 | 4 | |a KCCQ | |
| 650 | 4 | |a Mortality | |
| 700 | 1 | |a Leite, Ana Rita |e verfasserin |4 aut | |
| 700 | 1 | |a Neves, João Sérgio |e verfasserin |4 aut | |
| 700 | 1 | |a Saraiva, Francisca |e verfasserin |4 aut | |
| 700 | 1 | |a Brochado, Liliana |e verfasserin |4 aut | |
| 700 | 1 | |a Oliveira, Ana Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Butler, Javed |e verfasserin |4 aut | |
| 700 | 1 | |a Packer, Milton |e verfasserin |4 aut | |
| 700 | 1 | |a Zannad, Faiez |e verfasserin |4 aut | |
| 700 | 1 | |a Vasques-Nóvoa, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Leite-Moreira, Adelino |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreira, João Pedro |e verfasserin |4 aut | |
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