PMID- 37874564
OWN - NLM
STAT- MEDLINE
DCOM- 20231027
LR  - 20231027
IS  - 2574-3805 (Electronic)
IS  - 2574-3805 (Linking)
VI  - 6
IP  - 10
DP  - 2023 Oct 2
TI  - New York Heart Association Class and Kansas City Cardiomyopathy Questionnaire in 
      Acute Heart Failure.
PG  - e2339458
LID - 10.1001/jamanetworkopen.2023.39458 [doi]
LID - e2339458
AB  - IMPORTANCE: Sparse data exist regarding how clinician-assigned New York Heart 
      Association (NYHA) class compares with heart failure (HF)-specific Kansas City 
      Cardiomyopathy Questionnaire (KCCQ) in acute HF. OBJECTIVE: To compare 
      concordance between NYHA class and KCCQ overall summary score (KCCQ-OS) in acute 
      HF and investigate associations of changes in NYHA class and KCCQ-OS with 
      long-term outcomes. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, 
      patients with HF were enrolled from 52 hospitals in China between August 2016 and 
      May 2018. Among patients with NYHA class and KCCQ-OS at admission and 1 month, 
      levels of each scale were categorized into 4 groups from worst to best. Mild and 
      moderate to severe discordance were defined as NYHA class and KCCQ-OS differing 
      by 1 level or 2 or more levels, respectively. Multivariable models evaluated 
      associations between improvements in the 2 measures and outcomes. Analysis was 
      conducted from January to March 2023. EXPOSURE: Changes in NYHA class and KCCQ-OS 
      from admission to 1 month. MAIN OUTCOMES AND MEASURES: All-cause mortality, 
      cardiovascular death, or first HF rehospitalization. RESULTS: A total of 2683 
      patients (1709 [63.7%] male; median [IQR] age, 66 [56-75] years) were included. 
      NYHA class II, III, and IV were presented in 374 patients (13.9%), 1179 patients 
      (44.0%), and 1130 patients (42.1%), respectively, and the median (IQR) KCCQ-OS 
      was 44.4 (28.3-61.9). Concordance, mild discordance, and moderate to severe 
      discordance between admission NYHA class and KCCQ-OS occurred in 954 patients 
      (35.6%), 1203 patients (44.8%), and 526 patients (19.6%), respectively. For 
      KCCQ-OS, kernel density overlaps were 73.6% between NYHA II and III, 63.8% 
      between NYHA II and IV, and 88.3% between NYHA III and IV. Most patients 
      experienced improvements in NYHA and KCCQ-OS from admission to 1 month. After 
      adjustment, there was no significant association between improvements in NYHA 
      class and 4-year all-cause mortality, whereas 5 or more point improvements in 
      KCCQ-OS were independently associated with a lower risk of 4-year mortality 
      (hazard ratio, 0.84; 95% CI, 0.74-0.96; P = .01). NYHA class and KCCQ-OS 
      improvements were both associated with decreased risk of 1-year composite 
      cardiovascular death or HF rehospitalization. CONCLUSIONS AND RELEVANCE: In this 
      cohort study of acute HF, discordance between NYHA class and KCCQ was common, and 
      KCCQ was more relevant to subsequent mortality than NYHA class.
FAU - Huo, Xiqian
AU  - Huo X
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Pu, Boxuan
AU  - Pu B
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Wang, Wei
AU  - Wang W
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Peng, Yue
AU  - Peng Y
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Li, Jingkuo
AU  - Li J
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Lei, Lubi
AU  - Lei L
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Zhang, Lihua
AU  - Zhang L
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
FAU - Li, Jing
AU  - Li J
AD  - National Clinical Research Center for Cardiovascular Diseases, State Key 
      Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for 
      Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union 
      Medical College, Beijing, People's Republic of China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20231002
PL  - United States
TA  - JAMA Netw Open
JT  - JAMA network open
JID - 101729235
SB  - IM
MH  - Humans
MH  - Male
MH  - Aged
MH  - Female
MH  - Quality of Life
MH  - Kansas/epidemiology
MH  - Cohort Studies
MH  - New York
MH  - *Heart Failure
MH  - *Cardiomyopathies
MH  - Surveys and Questionnaires
PMC - PMC10599126
COIS- Conflict of Interest Disclosures: Dr Jing Li reported receiving grants from Fuwai 
      Hospital, the Chinese government, and Chinese Academy of Medical Sciences; 
      receiving research agreements through the National Center for Cardiovascular 
      Diseases and Fuwai Hospital from Amgen; receiving a research agreement through 
      Fuwai Hospital from Sanofi; receiving a research agreement through Fuwai Hospital 
      with the University of Oxford; receiving a research agreement through the 
      National Center for Cardiovascular Diseases from AstraZeneca; and receiving a 
      research agreement through the National Center for Cardiovascular Diseases from 
      Lilly. No other disclosures were reported.
EDAT- 2023/10/24 12:42
MHDA- 2023/10/27 06:43
PMCR- 2023/10/24
CRDT- 2023/10/24 11:33
PHST- 2023/10/27 06:43 [medline]
PHST- 2023/10/24 12:42 [pubmed]
PHST- 2023/10/24 11:33 [entrez]
PHST- 2023/10/24 00:00 [pmc-release]
AID - 2810989 [pii]
AID - zoi231151 [pii]
AID - 10.1001/jamanetworkopen.2023.39458 [doi]
PST - epublish
SO  - JAMA Netw Open. 2023 Oct 2;6(10):e2339458. doi: 
      10.1001/jamanetworkopen.2023.39458.