Relationship of quality of life scores with baseline characteristics and outcomes in the African-American heart failure trial.
Relationship of quality of life scores with baseline characteristics and outcomes in the African-American heart failure trial.
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DOI：
10.1016/j.cardfail.2009.05.016
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发表时间：
2009-12-01
影响因子：
6
通讯作者：
Anand, Inder S
中科院分区：
文献类型：
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作者：
Carson, Peter;Tam, S William;Anand, Inder S
背景技术背景：描述非裔美国人心力衰竭试验（A-HeFT）中与基线评分、评分与预后的关系以及对硝酸异山梨酯/肼苯哒嗪（FDC I/H）固定剂量复方制剂治疗反应相关的因素的生活质量（QOL）。关于非裔美国人心力衰竭患者的QOL评分或这些评分在任何人群中的预后价值的数据有限。最后，FDC I/H对QOL评分的影响，特别是在A-HeFT中，尚不清楚。方法和结果：A-HeFT随机分配了1050例患有纽约心脏协会（NYHA）III-IV级心力衰竭和收缩功能障碍的非洲裔美国患者。在基线和3个月间隔时使用明尼苏达心力衰竭生活问卷（MLHFQ）进行QOL测量。基线时，MLHFQ评分较差与年龄较小、女性、体重指数较大、非缺血性病因、心率和NYHA分级高、收缩压低和慢性阻塞性肺病相关。基线和MLHFQ评分的变化与合并的全因死亡率或心力衰竭住院的高风险相关（基线P < .0001，3个月P=.001，6个月P=.0008），但与死亡率无关。FDC I/H治疗显着改善MLHFQ评分与placebo.CONCLUSIONS：在A-HeFT，基线生活质量（MLHFQ）评分和评分的变化预测合并HF发病率和死亡率的结果。与安慰剂相比，FDC I/H持续改善A-HeFT的QOL评分。
BACKGROUND: To characterize the quality of life (QOL) in the African-American Heart Failure Trial (A-HeFT) for factors associated with baseline score, relation of score to prognosis, and response to therapy with a fixed-dose combination of isosorbide dinitrate/hydralazine (FDC I/H). Limited data exist on QOL scores in African-American heart failure patients or on the prognostic value of theses scores in any population. Finally, the effect of FDC I/H on QOL scores, particularly in A-HeFT, is not known.METHODS AND RESULTS: A-HeFT randomized 1050 African-American patients with New York Heart Association (NYHA) Class III-IV heart failure and systolic dysfunction. QOL measurements using Minnesota Living with Heart Failure Questionnaire (MLHFQ) were done at baseline and 3-month intervals. At baseline, worse MLHFQ scores were associated with younger age, female sex, greater body mass index, nonischemic etiology, high heart rate and NYHA Class, low systolic blood pressure, and chronic obstructive pulmonary disease. Both baseline and change in MLHFQ score were associated with a higher risk for combined all-cause mortality or heart failure hospitalization (baseline P < .0001, change at 3 months P=.001, and at 6 months P=.0008), but not mortality. Treatment with FDC I/H significantly improved MLHFQ score compared with placebo.CONCLUSIONS: In A-HeFT, baseline QOL (MLHFQ) scores and change in score were predictive of combined HF morbidity and mortality outcomes. FDC I/H consistently improved QOL scores in A-HeFT compared with placebo.