Abstract 12069: A New Composite Risk Score of QOL and Self-Care Predicts Cardiac Events in Japanese Patients With Heart Failure
Background: Quality of life (QOL) is often used as a surrogate marker to predict patient’s prognosis in heart failure (HF). Self-care is also a crucial mediator related to clinical outcomes. We aimed at clarifying whether a new composite risk score of QOL and self-care predict cardiac events in HF patients.
Methods: A total of 278 patients with HF were enrolled into this study (age 64 ± 14, 71% male). QOL was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHFQ), in which a higher score indicates a worse QOL. A HF self-care risk score that we developed previously was calculated by counting the number of poor adherence to five self-care behaviors (medication, eating a low-sodium diet, exercise regularly, daily weighing, and seeking help behavior).
Results: The MLHFQ score was 34.3±22.1. Poor adherence to medication, eating a low-sodium diet, exercise regularly, daily weighing, and seeking help behavior was observed in 6%, 64%, 62%, 49%, and 71%, respectively. During a 2-year follow-up, 47 patients (17%) had hospitalization for HF and/or cardiac death. Cox regression analysis showed that both the MLHFQ score and the HF self-care risk score were related to the clinical outcomes [hazard ratio (HR) =1.03, 95% confidence interval (CI) =1.02 to 1.04, p≤0.01; HR=2.39, 95%CI=1.15 to 4.94, p=0.02] . On the basis of the results from ROC curve analysis and logistic regression analyses, we developed a new composite risk score of QOL and self-care. As shown in Figure, the new score successfully predict cardiac events (HR=1.27, 95%CI=1.16 to 1.40, p≤0.01). Area under the curve of the new score was larger than that in the HF self-care risk score (0.729 vs. 0.594, p≤0.01). The predictability of the new composite risk score remained to be significant after adjustment for age, BNP, and medical therapy including beta-blocker (p≤0.01).
Conclusions: A new composite risk score of QOL and self-care can provide additional information on prognosis in HF patients.
- © 2013 by American Heart Association, Inc.