EuroQol 5-Dimension Questionnaire in Heart Failure With Reduced, Mildly Reduced, and Preserved Ejection Fraction: A Patient-Level Analysis of DAPA-HF and DELIVER

doi:10.1016/j.jchf.2024.10.020

EuroQol 5-Dimension Questionnaire in Heart Failure With Reduced, Mildly Reduced, and Preserved Ejection Fraction: A Patient-Level Analysis of DAPA-HF and DELIVER

JACC Heart FailPublication date not resolvedSecondary analysis of the DAPA-HF and DELIVER randomised trials

Cite

Authors' conclusion

The EQ-5D revealed problems not often associated (eg, pain) with HF or commonly quantified in HF (eg, anxiety/depression). Dapagliflozin improved multiple QoL dimensions, and possibly anxiety/depression.

Study context

Population: Patients with heart failure (HF) with reduced, mildly reduced or preserved EF (DAPA-HF and DELIVER)10,135 (92.1%) completed EQ-5D
Participants: 11,007 patients

Comparison: EQ-5D-LSS categories
Primary endpoint: CV death or worsening HF (time to first event) by EQ-5D-LSS

Methodological detailspooled patient-level analysis

Pooled patient-level analysis

Primary result

As reported in the abstract

CV death or worsening HF

Each group vs EQ-5D-LSS 5Hazard ratio (95% CI)

EQ-5D-LSS 6-10

1.27(1.10–1.47)

EQ-5D-LSS 11-15

1.70(1.46–1.98)

EQ-5D-LSS 16-25

2.31(1.88–2.85)

Further findings

Outcome	← Lower with dapagliflozin ←→ Higher with dapagliflozin →	OR (95% CI)	P value
Improvement in EQ-5D dimensions with dapagliflozin · 8 months — Dapagliflozin vs EQ-5D-LSS 5 · mobility	0.512	1.13 (1.04–1.23)	P = 0.004
Improvement in EQ-5D dimensions with dapagliflozin · 8 months — Dapagliflozin vs EQ-5D-LSS 5 · self-care	0.512	1.13 (1.02–1.24)	P = 0.016
Improvement in EQ-5D dimensions with dapagliflozin · 8 months — Dapagliflozin vs EQ-5D-LSS 5 · usual activities	0.512	1.11 (1.02–1.21)	P = 0.015
Improvement in EQ-5D dimensions with dapagliflozin · 8 months — Dapagliflozin vs EQ-5D-LSS 5 · anxiety/depression	0.512	1.10 (1.01–1.21)	P = 0.034
	0.512Odds ratio (log scale)

Improvement in EQ-5D dimensions with dapagliflozin — NNT for 1 patient to report improvement in EQ-5D-LSS: 31 (95% CI 20-72)

Baseline EQ-5D dimensions: no / slight / moderate or greater problem

Mobility: 37%, 30%, 33%
Self-care: 67%, 20%, 13%
Usual activities: 40%, 33%, 27%
Pain/discomfort: 45%, 32%, 23%
Anxiety/depression: 57%, 27%, 16%

Original publication

EuroQol 5-Dimension Questionnaire in Heart Failure With Reduced, Mildly Reduced, and Preserved Ejection Fraction: A Patient-Level Analysis of DAPA-HF and DELIVER. JACC Heart Fail. doi:10.1016/j.jchf.2024.10.020

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it