Multinational and multiethnic variations in health-related quality of life in patients with chronic heart failure.
Multinational and multiethnic variations in health-related quality of life in patients with chronic heart failure.
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DOI：
10.1016/j.ahj.2017.06.016
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发表时间：
2017-09
影响因子：
4.8
通讯作者：
HF-ACTION investigators
中科院分区：
文献类型：
--
作者：
Luo N;Teng TK;Tay WT;Anand IS;Kraus WE;Liew HB;Ling LH;O'Connor CM;Piña IL;Richards AM;Shimizu W;Whellan DJ;Yap J;Lam CSP;Mentz RJ;ASIAN-HF;HF-ACTION investigators
评估心力衰竭（HF）患者的健康相关生活质量（HRQoL）是临床护理和HF研究的重要目标。在控制人口统计学特征和HF严重程度的情况下，我们试图研究感知HRQoL的种族差异及其与HF和左心室射血分数≤ 35%患者死亡率的相关性。我们使用堪萨斯城心肌病问卷（KCCQ;范围0-100;评分越高反映健康状况越好）比较了HF-ACTION和ASIAN-HF多国研究中印度（26%）、白色（23%）、中国（17%）、日本/韩国（12%）、黑人（12%）和马来人（10%）的5,697例慢性HF患者。调整年龄、性别、教育状况、HF严重程度和风险因素后，马来人（58±22）和中国人（60±23）的KCCQ评分最低，黑人（64±21）和印度人（65±23）居中，白色人（67±20）和日本或韩国患者（67±22）最高。与黑人（80±21）和白色（82±19）患者相比，所有亚洲种族（尤其是日本人/韩国人[60±26]、马来人[66±23]和中国人[64±28]）的自我效能（衡量对症状管理能力的信心）均较低，即使在多变量调整后也是如此（p<0.001）。在所有种族中，KCCQ强烈预测1年死亡率（HR 0.45，KCCQ最高与最低五分位数的95% CI 0.30-0.67;种族相互作用p 0.101）。总体而言，HRQoL与慢性HF的死亡率呈负相关且独立相关，但不受种族影响。然而，种族差异存在独立的HF严重程度和合并症。这些数据可能对未来使用患者报告结局作为终点的全球临床HF试验具有重要意义。NCT 00047437和NCT 01633398
Assessing health-related quality of life (HRQoL) in patients with heart failure (HF) are important goals of clinical care and HF research. We sought to investigate ethnic differences in perceived HRQoL and its association with mortality among patients with HF and left ventricular ejection fraction ≤35%, controlling for demographic characteristics and HF severity. We compared 5,697 chronic HF patients of Indian (26%), White (23%), Chinese (17%), Japanese/Koreans (12%), Black (12%), and Malay (10%) ethnicities from the HF-ACTION and ASIAN-HF multinational studies using the Kansas City Cardiomyopathy Questionnaire (KCCQ; range 0–100; higher scores reflect better health status). KCCQ scores were lowest in Malay (58±22) and Chinese (60±23), intermediate in Black (64±21) and Indian (65±23), and highest in White (67±20) and Japanese or Korean patients (67±22), after adjusting for age, sex, educational status, HF severity and risk factors. Self-efficacy, which measures confidence in the ability to manage symptoms, was lower in all Asian ethnicities (especially Japanese/Koreans [60±26], Malay [66±23] and Chinese [64±28]) compared to Black (80±21) and White (82±19) patients, even after multivariable adjustment (p<0.001). In all ethnicities, KCCQ strongly predicted 1-year mortality (HR 0.45, 95% CI 0.30–0.67 for highest vs lowest quintile of KCCQ; p for interaction by ethnicity 0.101). Overall, HRQoL is inversely and independently related to mortality in chronic HF, but is not modified by ethnicity. Nevertheless, ethnic differences exist independent of HF severity and comorbidities. These data may have important implications for future global clinical HF trials that use patient-reported outcomes as endpoints. NCT00047437 and NCT01633398
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影响因子：
24
作者：
Heidenreich, PA;Spertus, JA;Williams, RE
通讯作者：
Williams, RE
影响因子：
5.9
作者：
Comin-Colet, Josep;Garin, Olatz;Elosua, Roberto
通讯作者：
Elosua, Roberto
影响因子：
13
作者：
Qian, Feng;Parzynski, Craig S.;Krumholz, Harlan M.
通讯作者：
Krumholz, Harlan M.
影响因子：
18.2
作者：
Pettersen, KI;Reikvam, A;Stavem, K
通讯作者：
Stavem, K
影响因子：
2.8
作者：
Jaarsma, T;Halfens, R;Diederiks, J
通讯作者：
Diederiks, J