Factors associated with health‐related quality of life in heart failure in 23 000 patients from 40 countries: results of the G‐CHF research programme

Aims To examine clinical and social correlates of health‐related quality of life (HRQL) in patients with heart failure (HF) from high‐ (HIC), upper middle‐ (UMIC), lower middle‐ (LMIC) and low‐income (LIC) countries. Methods and results Between 2017 and 2020, 23 292 patients with HF (32% inpatients, 61% men) from 40 countries were enrolled in the Global Congestive Heart Failure study. HRQL was recorded at baseline using the Kansas City Cardiomyopathy Questionnaire (KCCQ)‐12. In a cross‐sectional analysis, we compared age‐ and sex‐adjusted mean KCCQ‐12 summary scores (SS: 0–100, higher = better) between patients from different country income levels. We used multivariable linear regression examining correlations (estimated coefficients) of KCCQ‐12‐SS with sociodemographic, comorbidity, treatment and symptom covariates. The adjusted model (37 covariates) was informed by univariable findings, clinical importance and backward selection. Mean age was 63 years and 40% of patients were in New York Heart Association (NYHA) class III–IV. Average HRQL was 55 SD 27. It was 62.5 (95% confidence interval [CI] 62.0–63.1) in HIC, 56.8 (56.1–57.4) in UMIC, 48.6 (48.0–49.3) in LMIC, and 38.5 (37.3–39.7) in LICs (p