دورية أكاديمية
Comparing New York Heart Association Class and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure.
| العنوان: | Comparing New York Heart Association Class and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure. |
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| المؤلفون: | Cosiano MF; Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., A.V., J.H., R.J.M., S.J.G.)., Vista A; Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., A.V., J.H., R.J.M., S.J.G.)., Sun JL; Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.)., Alhanti B; Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.)., Harrington J; Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., A.V., J.H., R.J.M., S.J.G.)., Butler J; Department of Medicine, University of Mississippi Medical Center, Jackson (J.B.).; Baylor Scott and White Research Institute, Dallas, TX (J.B.)., Starling RC; Department of Cardiovascular Medicine, Heart and Vascular Institute, Kaufman Center for Heart Failure, Cleveland Clinic, OH (R.C.S.)., Mentz RJ; Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., A.V., J.H., R.J.M., S.J.G.).; Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.)., Greene SJ; Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., A.V., J.H., R.J.M., S.J.G.).; Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.). |
| المصدر: | Circulation. Heart failure [Circ Heart Fail] 2023 Jan; Vol. 16 (1), pp. e010107. Date of Electronic Publication: 2022 Oct 31. |
| نوع المنشور: | Randomized Controlled Trial; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101479941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-3297 (Electronic) Linking ISSN: 19413289 NLM ISO Abbreviation: Circ Heart Fail Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins |
| مواضيع طبية MeSH: | Heart Failure*/diagnosis , Heart Failure*/drug therapy, Humans ; Natriuretic Peptide, Brain/therapeutic use ; New York ; Treatment Outcome ; Patient Reported Outcome Measures ; Quality of Life |
| مستخلص: | Background: Alignment between clinician-reported New York Heart Association (NYHA) class compared and patient-reported outcomes among patients hospitalized for heart failure is unclear. Methods: ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) was a global randomized trial comparing nesiritide versus placebo among patients hospitalized for heart failure, irrespective of ejection fraction. Among patients with complete baseline data for NYHA class and the patient-reported EuroQOL-5 dimensions ([EQ-5D], both utility index and visual analog scale), levels of each scale were mapped across 4 prespecified categories "best" to "worst." Minor and moderate-severe discordance were defined as NYHA class and EQ-5D differing by 1 level and ≥2 levels, respectively. Multivariable models assessed factors independently associated with moderate-severe discordance, and associations between discordance and clinical outcomes. Results: Among 5741 patients, concordance, minor discordance, and moderate-severe discordance between NYHA class and EQ-5D utility index occurred in 22%, 40%, and 38% of patients, respectively. For NYHA class and EQ-5D visual analog scale, this categorization occurred in 29%, 48%, and 23%. Discordance was more often due to disproportionately higher EQ-5D score (78% of discordance cases with utility index, and 70% with visual analog scale). NYHA class IV, higher EQ-5D scores, race, and geographic region were among patient factors independently associated with moderate-severe discordance. Magnitude of discordance was not associated with clinical outcomes; however, EQ-5D utility index disproportionately worse than NYHA class was associated with increased 180-day mortality (adjusted hazard ratio 1.27 [95% CI, 1.01-1.60]; P =0.04). Conclusions: In a global trial cohort of patients hospitalized for heart failure, the majority of patients exhibited discordance between clinician-reported NYHA class and patient-reported health status. Multiple patient factors were independently associated with moderate-severe discordance, and patients who perceived their health status as worse than the clinician's perception had higher mortality. Registration: URL: http://www. Clinicaltrials: gov; Unique identifier: NCT00475852. |
| فهرسة مساهمة: | Keywords: NYHA class; functional status; heart failure; outpatients; patient-centered care; patient-reported outcome measures; prognosis |
| سلسلة جزيئية: | ClinicalTrials.gov NCT00475852 |
| المشرفين على المادة: | 114471-18-0 (Natriuretic Peptide, Brain) |
| تواريخ الأحداث: | Date Created: 20221031 Date Completed: 20230119 Latest Revision: 20230213 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1161/CIRCHEARTFAILURE.122.010107 |
| PMID: | 36314126 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1941-3297 |
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| DOI: | 10.1161/CIRCHEARTFAILURE.122.010107 |