April 12, 2007 — Repeated self-administration of a 23-item health status questionnaire by patients with post–myocardial infarction (MI) heart failure can help identify changes in their risk status that could potentially guide management decisions and the efficient use of provider resources, proposes a report published online in the April 9 Rapid Access issue of Circulation and scheduled for April 17 print publication.
Changes in how such patients rated their health status using the Kansas City Cardiomyopathy Questionnaire (KCCQ) correlated directly with all-cause mortality and the composite of cardiovascular mortality and hospitalization in an analysis that controlled for New York Heart Association functional class and other prognostic markers, report Mikhail Kosiborod, MD, from the Mid America Heart Institute in Kansas City, Missouri, and colleagues.
"Our findings suggest that although a single measurement of health status is prognostic, additional valuable prognostic information can be inferred from repeated health status measurements over time," the authors write. "This information can then be used to identify high-risk patients who may warrant a greater frequency of outpatient follow-up and more intense medical or device therapy to optimize their outcomes."
Introduced about 7 years ago, the KCCQ, like the older Minnesota Living With Heart Failure Questionnaire, has helped quantify responses to treatment in heart failure trials but has almost no role in clinical practice. But John A. Spertus, MD, MPH, a co-author of the current study who has tested the KCCQ's prognostic value in a variety of heart failure settings, told heartwire that the questionnaire can help guide the management of individual patients.
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