TY - JOUR
T1 - Health-Related Quality of Life in Older Patients with Heart Failure from before to Early after Advanced Surgical Therapies
T2 - Findings from the SUSTAIN-IT Study
AU - Grady, Kathleen L.
AU - Kao, Andrew
AU - Spertus, John A.
AU - Hsich, Eileen
AU - Dew, Mary Amanda
AU - Pham, Duc Thinh
AU - Hartupee, Justin
AU - Petty, Michael
AU - Cotts, William
AU - Pamboukian, Salpy V.
AU - Pagani, Francis D.
AU - Lampert, Brent
AU - Johnson, Maryl
AU - Murray, Margaret
AU - Takeda, Koji
AU - Yuzefpolskaya, Melana
AU - Silvestry, Scott
AU - Kirklin, James K.
AU - Andrei, Adin Cristian
AU - Elenbaas, Christian
AU - Baldridge, Abigail
AU - Yancy, Clyde
N1 - Funding Information:
This work was sponsored by the National Institutes of Health, National Institute on Aging, SUSTAIN-IT study (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support; R01AG047416, Dr Grady [Principal Investigator]).
Funding Information:
Dr Grady is a consultant for Amgen Inc; paid lecturer for American Heart Association; and received grant support from the National Institutes of Health (National Institute on Aging and National Heart‚ Lung‚ and Blood Institute). Dr Kao is a member of Advisory Board for CareDx and Bioventrix. Dr Spertus is a consultant for Amgen, Novartis, Bayer, Myokardia, and Janssen; Scientific Advisory Board, United HealthCare; Board of Directors, Blue Cross Blue Shield, Kansas City; and is a copyright holder to Kansas City Cardiomyopathy Questionnaire. Dr Pagani is a noncompensated scientific advisor for FineHeart Inc; member of Data Safety Board Member for Carmat and the National Heart, Lung, and Blood Institute PumpKIN Clinical Study; and grant support from the National Heart, Lung, and Blood Institute and Agency for Healthcare Research and Quality. Dr Petty receives speaking honorarium from Abbott Inc. M. Murray is a consultant on a research project at GE Healthcare. Dr Silvestry is a consultant for Abiomed, Medtronic, Syncardia, and Abbott. Dr Kirklin is a director of the Data and Clinical Consulting Center of the Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support and receives grant support from the National Institutes of Health/National Institute on Aging. Dr Yancy reports spousal employment at Abbott Labs Inc. The other authors report no conflicts.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: Restoring health-related quality of life (HRQOL) is a therapeutic goal for older patients with advanced heart failure. We aimed to describe change in HRQOL in older patients (60-80 years) awaiting heart transplantation (HT) with or without pretransplant mechanical circulatory support (MCS) or scheduled for long-term MCS, if ineligible for HT, from before to 6 months after these surgeries and identify factors associated with change. Methods: Patients from 13 US sites completed the EuroQol 5-dimension 3L questionnaire and Kansas City Cardiomyopathy Questionnaire-12 at baseline and 3 and 6 months after HT or long-term MCS. Analyses included univariate comparisons and multivariable linear regression. Results: Among 305 participants (cohort mean age=66.2±4.7 years, 78% male, 84% White, 55% New York Heart Association class IV), 161 underwent HT (n=68 with and n=93 without pretransplant MCS), and 144 received long-term MCS. From baseline to 3 months, EuroQol 5-dimension visual analog scale scores improved in HT patients without pretransplant MCS (54.5±24.3 versus 75.9±16.0, P<0.001) and long-term MCS patients (45.7±22.9 versus 66.2± 20.9, P <0.001); while Kansas City Cardiomyopathy Questionnaire-12 overall summary scores improved in all 3 groups (HT without pretransplant MCS: 47.2±20.9 versus 77.4±20.1, P <0.001; long-term MCS: 35.3±20.2 versus 58.6±22.0, P <0.001; and HT with pretransplant MCS: 58.3±23.6 versus 72.1±23.5, P=0.002). No further HRQOL improvement was found from 3 to 6 months. Factors most significantly associated with change in HRQOL, baseline 3 months, were right heart failure and 3-month New York Heart Association class, and 3 to 6 months, were 6-month New York Heart Association class and major bleeding. Conclusions: In older heart failure patients, HRQOL improved from before to early after HT and long-term MCS. At 6 postoperative months, HRQOL of long-term MCS patients was lower than one or both HT groups. Understanding change in HRQOL from before to early after these surgeries may enhance decision-making and guide patient care. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02568930.
AB - Background: Restoring health-related quality of life (HRQOL) is a therapeutic goal for older patients with advanced heart failure. We aimed to describe change in HRQOL in older patients (60-80 years) awaiting heart transplantation (HT) with or without pretransplant mechanical circulatory support (MCS) or scheduled for long-term MCS, if ineligible for HT, from before to 6 months after these surgeries and identify factors associated with change. Methods: Patients from 13 US sites completed the EuroQol 5-dimension 3L questionnaire and Kansas City Cardiomyopathy Questionnaire-12 at baseline and 3 and 6 months after HT or long-term MCS. Analyses included univariate comparisons and multivariable linear regression. Results: Among 305 participants (cohort mean age=66.2±4.7 years, 78% male, 84% White, 55% New York Heart Association class IV), 161 underwent HT (n=68 with and n=93 without pretransplant MCS), and 144 received long-term MCS. From baseline to 3 months, EuroQol 5-dimension visual analog scale scores improved in HT patients without pretransplant MCS (54.5±24.3 versus 75.9±16.0, P<0.001) and long-term MCS patients (45.7±22.9 versus 66.2± 20.9, P <0.001); while Kansas City Cardiomyopathy Questionnaire-12 overall summary scores improved in all 3 groups (HT without pretransplant MCS: 47.2±20.9 versus 77.4±20.1, P <0.001; long-term MCS: 35.3±20.2 versus 58.6±22.0, P <0.001; and HT with pretransplant MCS: 58.3±23.6 versus 72.1±23.5, P=0.002). No further HRQOL improvement was found from 3 to 6 months. Factors most significantly associated with change in HRQOL, baseline 3 months, were right heart failure and 3-month New York Heart Association class, and 3 to 6 months, were 6-month New York Heart Association class and major bleeding. Conclusions: In older heart failure patients, HRQOL improved from before to early after HT and long-term MCS. At 6 postoperative months, HRQOL of long-term MCS patients was lower than one or both HT groups. Understanding change in HRQOL from before to early after these surgeries may enhance decision-making and guide patient care. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02568930.
KW - decision-making
KW - heart failure
KW - heart transplantation
KW - mechanical circulatory support
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85140271949&partnerID=8YFLogxK
U2 - 10.1161/CIRCHEARTFAILURE.122.009579
DO - 10.1161/CIRCHEARTFAILURE.122.009579
M3 - Article
C2 - 36214123
AN - SCOPUS:85140271949
SN - 1941-3289
VL - 15
SP - E009579
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
IS - 10
ER -