Introduction: Heart failure with reduced ejection fraction (HFrEF) is a common condition that significantly impacts patients’ health status - their symptoms, function, and quality of life. There are no current descriptions of the health status of HFrEF patients in clinical care and whether or not disparities in symptom control and quality of life exist by socioeconomic status or gender.
Methods: In the CHAMP-HF registry, the independent association between gender and socioeconomic status with health status, as measured by the KCCQ Overall Summary Score (a disease-specific measure; range 0-100 with higher scores indicating fewer symptoms, limitations and better quality of life), was compared among 3494 patients from 140 US clinics. Socioeconomic status was categorized by total household income. Multivariable linear regression with a random effect for site was performed to examine the mean difference in KCCQ score by socioeconomic status and gender, after adjusting for 37 covariates accounting for disease severity, socioeconomic status, laboratory and treatment characteristics.
Results: The mean (SD) KCCQ summary score for all patients was 64.2±24 and was lower for women (60.3±24) than men (65.9±24), with women comprising 29% of the sample. Patients with the lowest household income (57.1±23) had markedly worse health status than those with higher income (4.8-15.3 points; Table 1). In fully-adjusted models, women’s KCCQ scores were 1.8 points lower than men’s (p=0.03) and those with the highest income had 4.7-point higher KCCQ scores than those with the lowest income (p = 0.04).
Conclusion: In the first large assessment of health status in patients with HFrEF, we found that women and lower income patients had significantly worse KCCQ scores after multivariable adjustment. Those populations may benefit from more frequent monitoring and titration of medical therapy to eradicate these disparities.