Patients with comorbid diabetes may have a worse health-related quality of life (HRQOL) throughout their longitudinal experience, according to research published Nov. 11 in the Journal of the American College of Cardiology, which will be presented at AHA 2019 in Philadelphia, PA.

Using data from the CHAMP-HF registry, Muthiah Vaduganathan, MD, MPH, et al., explored longitudinal changes in HRQOL among ambulatory patients with comorbid diabetes and heart failure with reduced ejection fraction (HFrEF). Researchers looked at 4,983 adults in 152 U.S. sites with chronic HFrEF receiving at least one oral HF therapy from December 2015 to October 2019. Patients were paired at baseline and 12-month of two validated questionnaires: the Kansas City Cardiomyopathy Questionnaire (KCCQ), a validated multi-domain HF-specific tool with scores ranging from 0 – 100, and the EuroQol-5 Dimension (EQ5D).

Results showed that 2,085 patients (42 percent) had a history of diabetes, and that patients with diabetes had lower baseline KCCQ overall summary and EQ-5D scores vs. those without diabetes. Absolute differences across KCCQ domains ranged from about 3 to 6 (quality of life 3.2; social limitations 4.4; symptom frequency 5.1; and physical limitations 6.2). After accounting for covariates, patients with diabetes had 2.8 lower adjusted KCCQ overall summary scores.

Furthermore, the authors found that half of patients experienced clinically meaningful five-point improvements in KCCQ overall summary scores by one year, regardless of diabetes status. They note that this finding may reflect favorable perceptions of health under study observation, selective retention of a healthier cohort or regression to the mean.

The authors conclude that these data corroborate the broad health consequences of diabetes adversely impacting patient experience and inform designs of studies employing HRQOL as an endpoint.

Clinical Topics: Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Acute Heart Failure

Keywords: AHA Annual Scientific Sessions, AHA19, Quality of Life, Stroke Volume, Cohort Studies, Heart Failure, Ventricular Dysfunction, Left, Registries, Diabetes Mellitus, Cardiomyopathies

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