Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study
Background There is a paucity of research describing health‐related quality of life (HRQOL) in older adults considered for advanced heart failure surgical therapies. Using data from our SUSTAIN‐IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support) study, we aimed to com...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.024385 |
| _version_ | 1797858996389937152 |
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| author | Kathleen L. Grady Adin‐Cristian Andrei Christian Elenbaas Anna Warzecha Abigail Baldridge Andrew Kao John A. Spertus Duc‐Thinh Pham Mary Amanda Dew Eileen Hsich William Cotts Justin Hartupee Salpy V. Pamboukian Francis D. Pagani Michael Petty Brent Lampert Maryl Johnson Margaret Murray Koji Takeda Melana Yuzefpolskaya Scott Silvestry James K. Kirklin Clyde Yancy |
| author_facet | Kathleen L. Grady Adin‐Cristian Andrei Christian Elenbaas Anna Warzecha Abigail Baldridge Andrew Kao John A. Spertus Duc‐Thinh Pham Mary Amanda Dew Eileen Hsich William Cotts Justin Hartupee Salpy V. Pamboukian Francis D. Pagani Michael Petty Brent Lampert Maryl Johnson Margaret Murray Koji Takeda Melana Yuzefpolskaya Scott Silvestry James K. Kirklin Clyde Yancy |
| author_sort | Kathleen L. Grady |
| collection | DOAJ |
| description | Background There is a paucity of research describing health‐related quality of life (HRQOL) in older adults considered for advanced heart failure surgical therapies. Using data from our SUSTAIN‐IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support) study, we aimed to compare HRQOL among 3 groups of older (60–80 years) patients with heart failure before heart transplantation (HT) or long‐term mechanical circulatory support (MCS) and identify factors associated with HRQOL: (1) HT candidates with MCS, (2) HT candidates without MCS, or (3) candidates ineligible for HT and scheduled for long‐term MCS. Methods and Results Patients from 13 US sites completed assessments, including self‐reported measures of HRQOL (EuroQol‐5 Dimension Questionnaire, Kansas City Cardiomyopathy Questionnaire–12), depressive symptoms (Personal Health Questionnaire–8), anxiety (State‐Trait Anxiety Inventory–state form), cognitive status (Montreal Cognitive Assessment), and performance‐based measures (6‐minute walk test and 5‐m gait speed). Analyses included ANOVA, χ2 tests, Fisher’s exact tests, and linear regression. The sample included 393 patients; the majority of patients were White men and married. Long‐term MCS candidates (n=154) were significantly older and had more comorbidities and a higher New York Heart Association class than HT candidates with MCS (n=118) and HT candidates without MCS (n=121). Long‐term MCS candidates had worse HRQOL than HT candidates with and without MCS (EQ‐5D visual analog scale scores, 46±23 versus 68±18 versus 54±23 [P<0.001] and Kansas City Cardiomyopathy Questionnaire–12 overall summary scores, 35±21 versus 60±21 versus 49±22 [P<0.001], respectively). In multivariable analyses, lower 6‐minute walk distance, higher New York Heart Association class, depressive symptoms, and not being an HT candidate with MCS were significantly associated with worse overall HRQOL. Conclusions Our findings demonstrate important differences in overall and domain‐specific HRQOL of older patients with heart failure before HT or long‐term MCS. Understanding HRQOL differences may guide decisions toward more appropriate and personalized advanced heart failure therapies. |
| first_indexed | 2024-04-09T21:22:22Z |
| format | Article |
| id | doaj.art-176761c55bbc4119b7388f3bdb3794f7 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T21:22:22Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-176761c55bbc4119b7388f3bdb3794f72023-03-28T04:20:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-02-0111410.1161/JAHA.121.024385Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT StudyKathleen L. Grady0Adin‐Cristian Andrei1Christian Elenbaas2Anna Warzecha3Abigail Baldridge4Andrew Kao5John A. Spertus6Duc‐Thinh Pham7Mary Amanda Dew8Eileen Hsich9William Cotts10Justin Hartupee11Salpy V. Pamboukian12Francis D. Pagani13Michael Petty14Brent Lampert15Maryl Johnson16Margaret Murray17Koji Takeda18Melana Yuzefpolskaya19Scott Silvestry20James K. Kirklin21Clyde Yancy22Department of Surgery Northwestern University Chicago ILDepartment of Preventive Medicine Northwestern University Chicago ILDepartment of Surgery Northwestern University Chicago ILDepartment of Surgery Northwestern University Chicago ILDepartment of Surgery Northwestern University Chicago ILDepartment of Medicine St. Luke’s Medical Center Kansas City MODepartment of Medicine University of Missouri‐Kansas City Kansas City MODepartment of Surgery Northwestern University Chicago ILDepartment of Psychiatry University of Pittsburgh Pittsburgh PADepartment of Cardiovascular Medicine Cleveland Clinic Cleveland OHAdvocate Heart Institute Advocate Christ Medical Center Oak Lawn ILDepartment of Medicine Washington University St. Louis MODepartment of Medicine University of Alabama‐Birmingham Birmingham ALDepartment of Cardiac Surgery University of Michigan Ann Arbor MIDepartment of Nursing University of Minnesota Medical Center Minneapolis MNDepartment of Internal Medicine Ohio State University Columbus OHDepartment of Medicine University of Wisconsin Madison WIUniversity of Wisconsin Hospitals and ClinicsUniversity of Wisconsin Madison WIDepartment of Surgery Columbia University New York NYDepartment of Medicine Columbia University New York NYAdventHealth Transplant Institute Florida Hospital Orlando FLDepartment of Surgery University of Alabama‐Birmingham Birmingham ALDepartment of Medicine Northwestern University Chicago ILBackground There is a paucity of research describing health‐related quality of life (HRQOL) in older adults considered for advanced heart failure surgical therapies. Using data from our SUSTAIN‐IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support) study, we aimed to compare HRQOL among 3 groups of older (60–80 years) patients with heart failure before heart transplantation (HT) or long‐term mechanical circulatory support (MCS) and identify factors associated with HRQOL: (1) HT candidates with MCS, (2) HT candidates without MCS, or (3) candidates ineligible for HT and scheduled for long‐term MCS. Methods and Results Patients from 13 US sites completed assessments, including self‐reported measures of HRQOL (EuroQol‐5 Dimension Questionnaire, Kansas City Cardiomyopathy Questionnaire–12), depressive symptoms (Personal Health Questionnaire–8), anxiety (State‐Trait Anxiety Inventory–state form), cognitive status (Montreal Cognitive Assessment), and performance‐based measures (6‐minute walk test and 5‐m gait speed). Analyses included ANOVA, χ2 tests, Fisher’s exact tests, and linear regression. The sample included 393 patients; the majority of patients were White men and married. Long‐term MCS candidates (n=154) were significantly older and had more comorbidities and a higher New York Heart Association class than HT candidates with MCS (n=118) and HT candidates without MCS (n=121). Long‐term MCS candidates had worse HRQOL than HT candidates with and without MCS (EQ‐5D visual analog scale scores, 46±23 versus 68±18 versus 54±23 [P<0.001] and Kansas City Cardiomyopathy Questionnaire–12 overall summary scores, 35±21 versus 60±21 versus 49±22 [P<0.001], respectively). In multivariable analyses, lower 6‐minute walk distance, higher New York Heart Association class, depressive symptoms, and not being an HT candidate with MCS were significantly associated with worse overall HRQOL. Conclusions Our findings demonstrate important differences in overall and domain‐specific HRQOL of older patients with heart failure before HT or long‐term MCS. Understanding HRQOL differences may guide decisions toward more appropriate and personalized advanced heart failure therapies.https://www.ahajournals.org/doi/10.1161/JAHA.121.024385advanced heart failurequality of lifeolder age |
| spellingShingle | Kathleen L. Grady Adin‐Cristian Andrei Christian Elenbaas Anna Warzecha Abigail Baldridge Andrew Kao John A. Spertus Duc‐Thinh Pham Mary Amanda Dew Eileen Hsich William Cotts Justin Hartupee Salpy V. Pamboukian Francis D. Pagani Michael Petty Brent Lampert Maryl Johnson Margaret Murray Koji Takeda Melana Yuzefpolskaya Scott Silvestry James K. Kirklin Clyde Yancy Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease advanced heart failure quality of life older age |
| title | Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study |
| title_full | Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study |
| title_fullStr | Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study |
| title_full_unstemmed | Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study |
| title_short | Health‐Related Quality of Life in Older Patients With Advanced Heart Failure: Findings From the SUSTAIN‐IT Study |
| title_sort | health related quality of life in older patients with advanced heart failure findings from the sustain it study |
| topic | advanced heart failure quality of life older age |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.024385 |
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