Quality of life and the associated risk of all-cause mortality in nonischemic heart failure

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  • Johan S Bundgaard, University of Copenhagen
  • ,
  • Jens J Thune, University of Copenhagen
  • ,
  • Gunnar Gislason, The Danish Heart Foundation, University of Copenhagen
  • ,
  • Emil L Fosbøl, University of Copenhagen
  • ,
  • Christian Torp-Pedersen, Aalborg University
  • ,
  • David Aagaard, University of Copenhagen
  • ,
  • Jens C Nielsen
  • Jens Haarbo, University of Copenhagen
  • ,
  • Anna M Thøgersen, Aalborg University
  • ,
  • Lars Videbæk, Odense University Hospital
  • ,
  • Gunnar Jensen, University of Copenhagen
  • ,
  • Line L Olesen, University of Copenhagen
  • ,
  • Søren L Kristensen, University of Copenhagen
  • ,
  • Susanne S. Pedersen, Odense University Hospital, University of Southern Denmark, Denmark
  • Lars Køber, University of Copenhagen
  • ,
  • Ulrik M Mogensen, University of Copenhagen

OBJECTIVES: To examine the association between health-related quality of life (HRQoL) and mortality in patients with heart failure (HF).

BACKGROUND: The potential association of HRQoL and mortality in patients with HF is unclear. We investigated this association in The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators (ICD) in Patients with Non-ischemic Systolic Heart Failure on Mortality (DANISH).

METHODS: In DANISH, a total of 1116 patients with non-ischemic systolic HF on guideline-recommended therapy were randomized to ICD therapy or usual clinical care. HRQoL was assessed at randomization using the disease-specific Minnesota Living with Heart Failure Questionnaire (MLHFQ, 0-105, high score indicating worse HRQoL). Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) for all-cause mortality according to MLHFQ above or below 45, as recommended by a recent meta-analysis, to identify patients with poor HRQoL.

RESULTS: HRQoL was completed by 935 (84%) patients at baseline with a median follow-up of 67 months (IQR 47-83). Patients with poor HRQoL (MLHFQ score > 45, median 60 (IQR 53-71),n = 350) had a higher incidence of all-cause mortality than patients with moderate/good HRQoL (MLHFQ ≤45, median 23 (IQR 13-33), n = 585), respectively 26% vs. 18% with an unadjusted HR of 1.57 (95% CI 1.19-2.08, p = .002), and an adjusted HR of 1.39 (95% CI 1.01-1.91, p = .04).

CONCLUSION: Poor HRQoL was associated with an increased risk of all-cause mortality after adjustment for traditional risk factors.

CLINICAL TRIAL REGISTRATION: https: //clinicaltrials.gov/ct2/show/NCT00542945(DANISH).

Original languageEnglish
JournalInternational Journal of Cardiology
Volume305
Pages (from-to)92-98
Number of pages7
ISSN0167-5273
DOIs
Publication statusPublished - Apr 2020

    Research areas

  • All-cause mortality, Health-related quality of life, Heart failure

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