BACKGROUND: Disease-specific health status instruments such as the Kansas City Cardiomyopathy Questionnaire (KCCQ) can quantify symptoms, functional limitations, and quality of life in patients with heart failure. Understanding the relationship between KCCQ scores and prognosis may assist clinicians in both interpreting KCCQ scores and stratifying risk in patients. METHODS AND RESULTS: We examined the prognostic value of the KCCQ in a prospective, international cohort of 1516 patients with heart failure after a recent acute myocardial infarction. We focused on the relationship between the KCCQ overall score (KCCQ-os), measured at the first outpatient visit (4 weeks after enrollment), and subsequent 1-year cardiovascular mortality or hospitalization (n=258, 20.3%). KCCQ-os was strongly associated with subsequent cardiovascular events in that those with a score > or =75 had an 84% 1-year event-free survival compared with 59% for those with a score <25 (P<0.001). After demographic and other clinical characteristics were controlled for in multivariable models, KCCQ-os remained strongly associated with outcome (hazard ratio, 2.02; 95% CI, 1.24 to 3.27 for KCCQ-os <25; P<0.001). CONCLUSIONS: In outpatients with heart failure complicating an acute myocardial infarction, KCCQ-os is strongly associated with subsequent 1-year cardiovascular mortality and hospitalization. Use of the KCCQ in outpatient clinical practice can both quantify patients' health status and provide insight into their prognosis.
BACKGROUND: Disease-specific health status instruments such as the Kansas City Cardiomyopathy Questionnaire (KCCQ) can quantify symptoms, functional limitations, and quality of life in patients with heart failure. Understanding the relationship between KCCQ scores and prognosis may assist clinicians in both interpreting KCCQ scores and stratifying risk in patients. METHODS AND RESULTS: We examined the prognostic value of the KCCQ in a prospective, international cohort of 1516 patients with heart failure after a recent acute myocardial infarction. We focused on the relationship between the KCCQ overall score (KCCQ-os), measured at the first outpatient visit (4 weeks after enrollment), and subsequent 1-year cardiovascular mortality or hospitalization (n=258, 20.3%). KCCQ-os was strongly associated with subsequent cardiovascular events in that those with a score > or =75 had an 84% 1-year event-free survival compared with 59% for those with a score <25 (P<0.001). After demographic and other clinical characteristics were controlled for in multivariable models, KCCQ-os remained strongly associated with outcome (hazard ratio, 2.02; 95% CI, 1.24 to 3.27 for KCCQ-os <25; P<0.001). CONCLUSIONS: In outpatients with heart failure complicating an acute myocardial infarction, KCCQ-os is strongly associated with subsequent 1-year cardiovascular mortality and hospitalization. Use of the KCCQ in outpatient clinical practice can both quantify patients' health status and provide insight into their prognosis.
Authors: Suzanne V Arnold; John A Spertus; Yang Lei; Philip Green; Ajay J Kirtane; Samir Kapadia; Vinod H Thourani; Howard C Herrmann; Nirat Beohar; Alan Zajarias; Michael J Mack; Martin B Leon; David J Cohen Journal: Circ Cardiovasc Qual Outcomes Date: 2013-09-10
Authors: Michael G Shlipak; James P Lash; Wei Yang; Valerie Teal; Martin Keane; Tom Cappola; Chris Keller; Kenneth Jamerson; John Kusek; Patrice Delafontaine; Jiang He; Edgar R Miller; Martin Schreiber; Alan S Go Journal: J Card Fail Date: 2011-01 Impact factor: 5.712
Authors: Suzanne V Arnold; John A Spertus; Sreekanth Vemulapalli; Zhuokai Li; Roland A Matsouaka; Suzanne J Baron; Amit N Vora; Michael J Mack; Matthew R Reynolds; John S Rumsfeld; David J Cohen Journal: JAMA Cardiol Date: 2017-04-01 Impact factor: 14.676
Authors: Merrill Thomas; Yevgeniy Khariton; Gregg C Fonarow; Suzanne V Arnold; Larry Hill; Michael E Nassif; Puza P Sharma; Javed Butler; Laine Thomas; Carol I Duffy; Adam D DeVore; Adrian Hernandez; Nancy M Albert; J Herbert Patterson; Fredonia B Williams; Kevin McCague; John A Spertus Journal: JACC Heart Fail Date: 2019-06-05 Impact factor: 12.035
Authors: Henneke Versteeg; Susanne S Pedersen; Ruud A M Erdman; Josephine W I van Nierop; Peter de Jaegere; Ron T van Domburg Journal: Qual Life Res Date: 2009-07-19 Impact factor: 4.147