Does race influence health-related quality of life outcomes in older patients who undergo advanced cardiac surgical therapies?

BACKGROUND

Racial minorities are disproportionately affected by heart failure (HF). We aimed to determine whether (1) older patients (60-80 years) with HF who underwent long-term mechanical circulatory support (MCS, i.e., destination therapy), compared to patients who underwent heart transplantation (HT), with (HT MCS) or without (HT non-MCS) pretransplant MCS, experienced noninferior change in overall health-related quality of life (HRQOL) by race (White vs racial minorities) from baseline to 1-year postoperatively and (2) race was a risk factor associated with overall HRQOL at 1-year postoperatively.

METHODS

Patients were recruited from 13 US medical centers ( = 305). Of the 305 patients who underwent surgery, 107 long-term MCS, 56 HT MCS, and 87 HT non-MCS had data through 1-year follow-up. Analyses included noninferiority (NI) testing using the Kansas City Cardiomyopathy-12 Questionnaire overall summary score (KCCQ-12 OSS, score range = 1[worst]-100[best] HRQOL) at baseline and 3-, 6-, and 12-months follow-up and multivariable linear regression.

RESULTS

The cohort's average age was 66 years, 78% were male, and 84% were White. The long-term MCS racial minority group did not demonstrate NI compared to the HT MCS and HT non-MCS racial minority groups, and the White long-term MCS group did not demonstrate NI compared to the White HT MCS and HT non-MCS groups. Sex (male) and surgical strategies (HT MCS and HT non-MCS) were positively associated with the KCCQ-12 OSS, whereas the number of postoperative adverse events was negatively associated.

CONCLUSIONS

Patients experienced improved HRQOL after surgery, regardless of race; demographic and clinical factors were associated with HRQOL.