Heart failure & cardiomyopathies
Comparing New York Heart Association Class and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure
Authors' conclusion
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.
Study context
- Population
- Patients hospitalized for HF, irrespective of EF, with complete baseline New York Heart Association (NYHA) class and EQ-5D data
- Participants
- 5,741 patients
- Comparison
- Clinician-reported NYHA class vs patient-reported EQ-5D
- Primary endpoint
- Concordance/discordance between NYHA class and EQ-5D (utility index and visual analog scale)
Methodological detailsglobal
- Global
Primary result
As reported in the abstract
Agreement between NYHA class and EQ-5D
EQ-5D utility index
EQ-5D visual analog scale
- Discordance due to disproportionately higher EQ-5D score, utility index
- 78%
- Discordance due to disproportionately higher EQ-5D score, visual analog scale
- 70%
Further findings
Clinical outcomes by discordance · 180 days
| Comparison | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| EQ-5D utility index worse than NYHA class180-day mortality | 1.27 (1.01–1.60) | P = 0.04 | |
| 0.512Adjusted hazard ratio (log scale) |
Factors associated with moderate-severe discordance
- NYHA class IV, higher EQ-5D scores, race and geographic region independently associated
Clinical outcomes by discordance · 180 days
- Magnitude of discordance not associated with clinical outcomes
Original publication
Comparing New York Heart Association Class and Patient-Reported Outcomes Among Patients Hospitalized for Heart Failure. Circ Heart Fail. Published 31 October 2022. doi:10.
Summarised from the published abstract; every number is checked against it