Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Qual Life Res. 2024 Oct;33(10):2743-2753. doi: 10.1007/s11136-024-03723-y. Epub 2024 Aug 6.
Transthyretin amyloid cardiomyopathy (ATTR-CM) is associated with severely impaired health-related quality of life (HRQL). HRQL is an independent predictor of outcome in heart failure (HF), but data on patients with ATTR-CM is scarce. This study therefore aims to evaluate the association of HRQL with outcome in ATTR-CM.
Patients from our prospective ATTR-CM registry were assessed using the Kansas City cardiomyopathy questionnaire (KCCQ), the Minnesota living with HF questionnaire (MLHFQ), and the EuroQol five dimensions questionnaire (EQ-5D). Cox regression analysis was utilised to assess the impact of HRQL on all-cause mortality.
167 patients [80 years; interquartile range (IQR): 76-84; 80.8% male] were followed for a median of 27.6 (IQR: 9.7-41.8) months. The primary endpoint of all-cause mortality was met by 43 (25.7%) patients after a median period of 16.2 (IQR: 9.1-28.1) months. In a univariate Cox regression for mortality, a 10-point change in the KCCQ implied a hazard ratio (HR) of 0.815 [95%-confidence interval (CI): 0.725-0.916; p = 0.001], in the EQ-5D VAS of 0.764 (95%-CI: 0.656-0.889; p < 0.001), and 1.163 (95%-CI: 1.114-1.433; p < 0.001) in the MLHFQ. After adjustment for established biomarkers of HF, all-cause mortality was predicted independently by the EQ-5D VAS (HR: 0.8; 95%-CI: 0.649-0.986; p = 0.037; per 10 points) and the MLHFQ (HR: 1.228; 95%-CI: 1.035-1.458; p = 0.019; per 10 points).
HRQL is a predictor of outcome in ATTR-CM. The EQ-5D VAS and the MLHFQ predict survival independent of biomarkers of HF.
转甲状腺素蛋白淀粉样心肌病（ATTR-CM）与严重的健康相关生活质量（HRQL）受损有关。HRQL 是心力衰竭（HF）结局的独立预测因素，但有关 ATTR-CM 患者的数据很少。因此，本研究旨在评估 HRQL 与 ATTR-CM 结局的关系。
我们前瞻性的 ATTR-CM 注册研究中的患者使用堪萨斯城心肌病问卷（KCCQ）、明尼苏达州心力衰竭生活质量问卷（MLHFQ）和欧洲五维健康问卷（EQ-5D）进行评估。利用 Cox 回归分析评估 HRQL 对全因死亡率的影响。
167 例患者[80 岁；四分位距（IQR）：76-84；80.8%为男性]中位随访 27.6（IQR：9.7-41.8）个月。中位时间为 16.2（IQR：9.1-28.1）个月时，43 例（25.7%）患者达到全因死亡率的主要终点。在全因死亡率的单变量 Cox 回归中，KCCQ 评分每增加 10 分，HR 为 0.815 [95%可信区间（CI）：0.725-0.916；p=0.001]，EQ-5D VAS 为 0.764（95%CI：0.656-0.889；p<0.001），MLHFQ 为 1.163（95%CI：1.114-1.433；p<0.001）。在调整 HF 的既定生物标志物后，EQ-5D VAS（HR：0.8；95%CI：0.649-0.986；p=0.037；每增加 10 分）和 MLHFQ（HR：1.228；95%CI：1.035-1.458；p=0.019；每增加 10 分）独立预测全因死亡率。
HRQL 是 ATTR-CM 结局的预测因素。EQ-5D VAS 和 MLHFQ 可预测 HF 生物标志物以外的生存率。
