Table 3.
Association Between Changes in KCCQ Overall Summary Score From Baseline to 12 Months With Clinical Outcomes in Patients With HFpEF and HFrEF
| HF Group (N=259) | HFpEF (N=141) | HFrEF (N=118) | P Value† | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of Events in Total N of Group | Unadjusted | Adjusted for Baseline KCCQ | Adjusted for Clinical Variables* | Number of Events in Total N of Group | Unadjusted | Adjusted for Baseline KCCQ | Adjusted for Clinical Variables* | Number of events in Total N of Group | Unadjusted | Adjusted for Baseline KCCQ | Adjusted for Clinical Variables* | ||
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |||||
| All‐cause death | |||||||||||||
| ≥5 points decrease in KCCQ OSS | 12/84 | 0.79 (0.38, 1.66) | 0.8 (0.38, 1.67) | 0.59 (0.28, 1.27) | 5/52 | 0.47 (0.16, 1.39) | 0.47 (0.16, 1.40) | 0.35 (0.11, 1.06) | 7/32 | 1.35 (0.49, 3.74) | 1.39 (0.50, 3.84) | 1.06 (0.37, 3.04) | 0.1563 |
| No change in KCCQ OSS | 17/96 | Ref | Ref | Ref | 9/50 | Ref | Ref | Ref | 8/46 | Ref | Ref | Ref | |
| ≥5 points increase in KCCQ OSS | 11/79 | 0.74 (0.35, 1.58) | 0.72 (0.33, 1.57) | 0.74 (0.34, 1.62) | 5/39 | 0.62 (0.21, 1.84) | 0.62 (0.19, 2.04) | 0.62 (0.19, 1.99) | 6/40 | 0.88 (0.30, 2.55) | 0.85 (0.29, 2.48) | 0.9 (0.31, 2.65) | 0.4927 |
| All‐cause death and/or rehospitalization‡ | |||||||||||||
| ≥5 points decrease in KCCQ OSS | 59/84 | 1.52 (1.04, 2.21) | 1.46 (1.00, 2.13) | 1.29 (0.87, 1.9) | 37/52 | 2.17 (1.27, 3.71) | 2.11 (1.23, 3.61) | 1.76 (1.01, 3.08) | 22/32 | 1.03 (0.59, 1.79) | 1.01 (0.58, 1.77) | 0.91 (0.52, 1.61) | 0.0848 |
| No change in KCCQ OSS | 50/96 | Ref | Ref | Ref | 21/50 | Ref | Ref | Ref | 29/46 | Ref | Ref | Ref | |
| ≥5 points increase in KCCQ OSS | 48/79 | 1.17 (1.14, 1.74) | 0.96 (0.64, 1.46) | 0.99 (0.65, 1.5) | 27/39 | 2.02 (1.14, 3.58) | 1.79 (0.97, 3.28) | 1.77 (0.97, 3.26) | 21/40 | 0.7 (0.4, 1.24) | 0.54 (0.3, 0.97) | 0.56 (0.31, 1.02) | 0.0272 |
| All‐cause death/cardiovascular hospitalization | |||||||||||||
| ≥5 points decrease in KCCQ OSS | 43/84 | 1.41 (0.91, 2.19) | 1.41 (0.91, 2.2) | 1.21 (0.77, 1.91) | 22/52 | 1.61 (0.82, 3.15) | 1.6 (0.82, 3.13) | 1.23 (0.62, 2.45) | 21/32 | 1.4 (0.77, 2.53) | 1.45 (0.8, 2.62) | 1.34 (0.73, 2.46) | 0.8466 |
| No change in KCCQ OSS | 37/96 | Ref | Ref | Ref | 14/50 | Ref | Ref | Ref | 23/46 | Ref | Ref | Ref | |
| ≥5 points increase in KCCQ OSS | 30/79 | 0.95 (0.59, 1.53) | 0.84 (0.51, 1.39) | 0.88 (0.53, 1.45) | 15/39 | 1.36 (0.66, 2.83) | 1.23 (0.57, 2.68) | 1.2 (0.56, 2.58) | 15/40 | 0.7 (0.36, 1.35) | 0.62 (0.32, 1.21) | 0.67 (0.34, 1.31) | 0.3618 |
| Cardiovascular hospitalization§ | |||||||||||||
| ≥5 points decrease in KCCQ OSS | 40/84 | 1.71 (1.07, 2.75) | 1.73 (1.08, 2.79) | 1.54 (0.95, 2.5) | 21/52 | 2.85 (1.26, 6.42) | 2.83 (1.26, 6.37) | 2.24 (0.98, 5.1) | 19/32 | 1.35 (0.74, 2.46) | 1.44 (0.78, 2.66) | 1.39 (0.75, 2.59) | 0.1758 |
| No change in KCCQ | 29/96 | Ref | Ref | Ref | 8/50 | Ref | Ref | Ref | 21/46 | Ref | Ref | Ref | |
| ≥5 points increase in KCCQ OSS | 28/79 | 1.16 (0.69, 1.96) | 0.99 (0.56, 1.74) | 1.02 (0.58, 1.79) | 14/39 | 2.35 (0.997, 5.55) | 2.08 (0.85, 5.11) | 2.04 (0.85, 4.93) | 14/40 | 0.72 (0.36, 1.43) | 0.61 (0.29, 1.29) | 0.63 (0.29, 1.36) | 0.0781 |
HFpEF indicates heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; HR, hazard ratio; KCCQ, Kansas City Cardiomyopathy Questionnaire; and OSS, overall summary score.
Adjusted for baseline KCCQ OSS and Meta‐Analysis Global Group In Chronic heart failure risk score.
P value for interaction between HF subtype and change in KCCQ OSS adjusted for baseline KCCQ OSS and MAGGIC risk score.
There were only 3 patients with death and without all‐cause hospitalization. Modeling of all‐cause hospitalization in the presence of death as competing risk was not attempted.
The hazard of cardiovascular hospitalization subdistribution was modelled. Fine and Gray models were used.