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 RK, Yang W, Roy J, Anderson AH, Bansal N, Chen J, DeFilippi C, Delafontaine P, Feldman HI, Kallem R, Kusek JW, Lora CM, Rosas SE, Go AS, and Shlipak MG
- Subjects
- Adult, Aged, Biomarkers blood, Cardiomyopathies physiopathology, Chi-Square Distribution, Disease Progression, Female, Heart Failure physiopathology, Humans, Hypertrophy, Left Ventricular diagnosis, Hypertrophy, Left Ventricular epidemiology, Hypertrophy, Left Ventricular physiopathology, Incidence, Logistic Models, Male, Middle Aged, Multivariate Analysis, Myocardial Contraction, Natriuretic Peptide, Brain blood, Odds Ratio, Peptide Fragments blood, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic diagnosis, Risk Assessment, Risk Factors, Time Factors, United States epidemiology, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left epidemiology, Ventricular Dysfunction, Left physiopathology, Ventricular Function, Left, Young Adult, Cardiomyopathies diagnosis, Cardiomyopathies epidemiology, Heart Failure diagnosis, Heart Failure epidemiology, Hospitalization, Renal Insufficiency, Chronic epidemiology, Surveys and Questionnaires
- Abstract
Background: Chronic 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 Results: We 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)., Conclusions: Symptoms 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., (© 2015 American Heart Association, Inc.)
- Published
- 2015
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