1. Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study
- Author
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Mishra, Rakesh K, Yang, Wei, Roy, Jason, Anderson, Amanda H, Bansal, Nisha, Chen, Jing, DeFilippi, Christopher, Delafontaine, Patrice, Feldman, Harold I, Kallem, Radhakrishna, Kusek, John W, Lora, Claudia M, Rosas, Sylvia E, Go, Alan S, Shlipak, Michael G, and CRIC Study Investigators
- Subjects
Adult ,Male ,Time Factors ,Kidney Disease ,Left ,Medical Physiology ,Renal and urogenital ,heart failure ,Cardiorespiratory Medicine and Haematology ,Cardiovascular ,Risk Assessment ,renal insufficiency ,Young Adult ,Natriuretic Peptide ,Clinical Research ,Risk Factors ,Surveys and Questionnaires ,Ventricular Dysfunction ,Odds Ratio ,Humans ,Ventricular Function ,2.1 Biological and endogenous factors ,Prospective Studies ,Chronic ,Aetiology ,Proportional Hazards Models ,Aged ,Chi-Square Distribution ,Incidence ,Brain ,Hypertrophy ,Middle Aged ,Myocardial Contraction ,Peptide Fragments ,United States ,Left Ventricular ,Hospitalization ,Logistic Models ,Heart Disease ,Cardiovascular System & Hematology ,CRIC Study Investigators ,Multivariate Analysis ,Disease Progression ,Female ,Biochemistry and Cell Biology ,Cardiomyopathies ,Biomarkers - Abstract
BackgroundChronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF.Methods and resultsWe studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4).ConclusionsSymptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors.
- Published
- 2015