PMID- 36314126
OWN - NLM
STAT- MEDLINE
DCOM- 20230119
LR  - 20230213
IS  - 1941-3297 (Electronic)
IS  - 1941-3289 (Linking)
VI  - 16
IP  - 1
DP  - 2023 Jan
TI  - Comparing New York Heart Association Class and Patient-Reported Outcomes Among 
      Patients Hospitalized for Heart Failure.
PG  - e010107
LID - 10.1161/CIRCHEARTFAILURE.122.010107 [doi]
AB  - BACKGROUND: Alignment between clinician-reported New York Heart Association 
      (NYHA) class compared and patient-reported outcomes among patients hospitalized 
      for heart failure is unclear. METHODS: ASCEND-HF (Acute Study of Clinical 
      Effectiveness of Nesiritide in Decompensated Heart Failure) was a global 
      randomized trial comparing nesiritide versus placebo among patients hospitalized 
      for heart failure, irrespective of ejection fraction. Among patients with 
      complete baseline data for NYHA class and the patient-reported EuroQOL-5 
      dimensions ([EQ-5D], both utility index and visual analog scale), levels of each 
      scale were mapped across 4 prespecified categories "best" to "worst." Minor and 
      moderate-severe discordance were defined as NYHA class and EQ-5D differing by 1 
      level and >/=2 levels, respectively. Multivariable models assessed factors 
      independently associated with moderate-severe discordance, and associations 
      between discordance and clinical outcomes. RESULTS: Among 5741 patients, 
      concordance, minor discordance, and moderate-severe discordance between NYHA 
      class and EQ-5D utility index occurred in 22%, 40%, and 38% of patients, 
      respectively. For NYHA class and EQ-5D visual analog scale, this categorization 
      occurred in 29%, 48%, and 23%. Discordance was more often due to 
      disproportionately higher EQ-5D score (78% of discordance cases with utility 
      index, and 70% with visual analog scale). NYHA class IV, higher EQ-5D scores, 
      race, and geographic region were among patient factors independently associated 
      with moderate-severe discordance. Magnitude of discordance was not associated 
      with clinical outcomes; however, EQ-5D utility index disproportionately worse 
      than NYHA class was associated with increased 180-day mortality (adjusted hazard 
      ratio 1.27 [95% CI, 1.01-1.60]; P=0.04). CONCLUSIONS: In a global trial cohort of 
      patients hospitalized for heart failure, the majority of patients exhibited 
      discordance between clinician-reported NYHA class and patient-reported health 
      status. Multiple patient factors were independently associated with 
      moderate-severe discordance, and patients who perceived their health status as 
      worse than the clinician's perception had higher mortality. Registration: URL: 
      http://www. CLINICALTRIALS: gov; Unique identifier: NCT00475852.
FAU - Cosiano, Michael F
AU  - Cosiano MF
AD  - Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., 
      A.V., J.H., R.J.M., S.J.G.).
FAU - Vista, Andrew
AU  - Vista A
AUID- ORCID: 0000-0003-2328-5961
AD  - Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., 
      A.V., J.H., R.J.M., S.J.G.).
FAU - Sun, Jie-Lena
AU  - Sun JL
AUID- ORCID: 0000-0002-4453-9441
AD  - Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.).
FAU - Alhanti, Brooke
AU  - Alhanti B
AD  - Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.).
FAU - Harrington, Josephine
AU  - Harrington J
AUID- ORCID: 0000-0001-5169-117X
AD  - Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., 
      A.V., J.H., R.J.M., S.J.G.).
FAU - Butler, Javed
AU  - Butler J
AUID- ORCID: 0000-0001-7683-4720
AD  - Department of Medicine, University of Mississippi Medical Center, Jackson (J.B.).
AD  - Baylor Scott and White Research Institute, Dallas, TX (J.B.).
FAU - Starling, Randall C
AU  - Starling RC
AUID- ORCID: 0000-0002-1254-4860
AD  - Department of Cardiovascular Medicine, Heart and Vascular Institute, Kaufman 
      Center for Heart Failure, Cleveland Clinic, OH (R.C.S.).
FAU - Mentz, Robert J
AU  - Mentz RJ
AUID- ORCID: 0000-0002-3222-1719
AD  - Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., 
      A.V., J.H., R.J.M., S.J.G.).
AD  - Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.).
FAU - Greene, Stephen J
AU  - Greene SJ
AUID- ORCID: 0000-0001-6912-7374
AD  - Department of Medicine, Duke University School of Medicine, Durham, NC (M.F.C., 
      A.V., J.H., R.J.M., S.J.G.).
AD  - Duke Clinical Research Institute, Durham, NC (J.-L.S., B.A., R.J.M., S.J.G.).
LA  - eng
SI  - ClinicalTrials.gov/NCT00475852
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20221031
PL  - United States
TA  - Circ Heart Fail
JT  - Circulation. Heart failure
JID - 101479941
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Humans
MH  - *Heart Failure/diagnosis/drug therapy
MH  - Natriuretic Peptide, Brain/therapeutic use
MH  - New York
MH  - Treatment Outcome
MH  - Patient Reported Outcome Measures
MH  - Quality of Life
OTO - NOTNLM
OT  - NYHA class
OT  - functional status
OT  - heart failure
OT  - outpatients
OT  - patient-centered care
OT  - patient-reported outcome measures
OT  - prognosis
EDAT- 2022/11/01 06:00
MHDA- 2023/01/20 06:00
CRDT- 2022/10/31 05:17
PHST- 2022/11/01 06:00 [pubmed]
PHST- 2023/01/20 06:00 [medline]
PHST- 2022/10/31 05:17 [entrez]
AID - 10.1161/CIRCHEARTFAILURE.122.010107 [doi]
PST - ppublish
SO  - Circ Heart Fail. 2023 Jan;16(1):e010107. doi: 
      10.1161/CIRCHEARTFAILURE.122.010107. Epub 2022 Oct 31.