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Health-Related Qual...
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Lewis, Eldrin F.
(författare)
Health-Related Quality of Life Outcomes in PARADIGM-HF
- Artikel/kapitelEngelska2017
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LIBRIS-ID:oai:gup.ub.gu.se/257828
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https://gup.ub.gu.se/publication/257828URI
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https://doi.org/10.1161/CIRCHEARTFAILURE.116.003430DOI
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Ämneskategori:art swepub-publicationtype
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© 2017 American Heart Association, Inc. Background Patients with heart failure and reduced ejection fraction have impaired health-related quality of life (HRQL) with variable responses to therapies that target mortality and heart failure hospitalizations. In PARADIGM-HF trial (Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] With ACEI [Angiotensin-Converting-Enzyme Inhibitor] to Determine Impact on Global Mortality and Morbidity in Heart Failure), sacubitril/valsartan reduced morbidity and mortality compared with enalapril. Another major treatment goal is to improve HRQL. Given improvements in mortality with sacubitril/valsartan, this analysis provides comprehensive assessment of impact of therapy on HRQL in survivors only. Methods and Results Patients (after run-in phase) completed disease-specific HRQL using Kansas City Cardiomyopathy Questionnaire (KCCQ) at randomization, 4 month, 8 month, and annual visits. Changes in KCCQ scores were calculated using repeated measures analysis of covariance model that adjusted for treatment and baseline values (principal efficacy prespecified at 8 months). Among the 8399 patients enrolled in PARADIGM-HF, 7623 (91%) completed KCCQ scores at randomization with complete data at 8 months for 6881 patients (90% of baseline). At 8 months, sacubitril/valsartan group noted improvements in both KCCQ clinical summary score (+0.64 versus -0.29; P=0.008) and KCCQ overall summary score (+1.13 versus -0.14; P < 0.001) in comparison to enalapril group and significantly less proportion of patients with deterioration (≥5 points decrease) of both KCCQ scores (27% versus 31%; P=0.01). Adjusted change scores demonstrated consistent improvements in sacubitril/valsartan compared with enalapril through 36 months. Conclusions Change scores in KCCQ clinical summary scores and KCCQ overall summary scores were better in patients treated with sacubitril/valsartan compared with those treated with enalapril, with consistency in most domains, and persist during follow-up beyond 8 months. These findings demonstrate that sacubitril/valsartan leads to better HRQL in surviving patients with heart failure. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01035255.
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Claggett, Brian L.
(författare)
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McMurray, John J.V.
(författare)
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Packer, Milton
(författare)
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Lefkowitz, Martin P.
(författare)
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Rouleau, Jean L.
(författare)
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Liu, Jiankang
(författare)
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Shi, Victor C.
(författare)
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Zile, Michael R.
(författare)
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Desai, Akshay S.
(författare)
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Solomon, Scott D.
(författare)
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Swedberg, Karl,1944Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xsweka
(författare)
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Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin
(creator_code:org_t)
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Ingår i:Circulation: Heart Failure101941-32891941-3297
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Lewis, Eldrin F.
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Claggett, Brian ...
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McMurray, John J ...
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Packer, Milton
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Lefkowitz, Marti ...
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Rouleau, Jean L.
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Liu, Jiankang
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Shi, Victor C.
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Zile, Michael R.
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Desai, Akshay S.
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Solomon, Scott D ...
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Swedberg, Karl, ...
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