Publication

Effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life among patients with acute heart failure

Journal Paper/Review - Aug 6, 2021

Units
PubMed
Doi

Citation
Belkin M, Münzel T, Erne P, Breidthardt T, Rickli H, Kobza R, de Oliveira Junior M, Danier I, Lopez-Ayala P, Kozhuharov N, Flores D, Walter J, Maeder M, Goudev A, Strebel I, Shrestha S, Gualandro D, Wussler D, Mueller C. Effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life among patients with acute heart failure. ESC Heart Fail 2021; 8:4218-4227.
Type
Journal Paper/Review (English)
Journal
ESC Heart Fail 2021; 8
Publication Date
Aug 6, 2021
Issn Electronic
2055-5822
Pages
4218-4227
Brief description/objective

AIMS
We aimed to assess the long-term effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life (HRQL) among patients with acute heart failure (AHF).

METHODS AND RESULTS
Health-related quality of life was prospectively assessed by the generic 3-levelled EQ-5D and the disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) among adult AHF patients enrolled in an international, multicentre, randomised, open-label blinded-end-point trial of a strategy that emphasized early intensive and sustained vasodilation using maximally tolerated doses of established oral and transdermal vasodilators according to systolic blood pressure. Changes in EQ-5D and KCCQ from admission to 180 day follow-up were individually compared between the intensive vasodilatation and the usual care group. Among 666 patients eligible for 180 day follow-up, 284 (43%, median age 79 years, 35% women) and 198 (30%, median age 77 years, 35% women) had completed the EQ-5D and KCCQ at baseline and follow-up, respectively. There was a significant improvement in HRQL as quantified by both, EQ-5D and KCCQ, from hospitalization to 180 day follow-up, with no significant differences in the change of HRQL between both treatment strategies. For instance, 39 (26%) versus 33 (25%) patients had an improvement by at least one level in at least two categories in the EQ-5D. Median increase in KCCQ overall summary score (KCCQ-OSS) was 17.6 (IQR 2.0-42.6) in the intervention group versus 18.5 (IQR 3.9-39.3) in the usual care group (P < 0.001 vs. baseline, P = 0.945 between groups).

CONCLUSIONS
Among patients with AHF, long-term HRQL quantified by EQ-5D and KCCQ improved substantially, with overall no significant differences between a strategy of comprehensive vasodilation versus usual care.