Trajectories of symptom scores and risk of cardiovascular events in the vulnerable phase of heart failure: an analysis using a latent class trajectory model - Report - MDSpire
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Symptom Score Patterns and Cardiovascular Event Risk During the Vulnerable Phase Post-Heart Failure Discharge: Insights from a Latent Class Trajectory Analysis
This study identifies distinct symptom trajectory patterns in patients post-heart failure discharge and their association with major adverse cardiovascular events (MACEs). A persistently declining symptom trajectory was linked to a significantly higher risk of MACEs compared to stable-moderate trajectories.
Background
The initial months following discharge for heart failure are critical, characterized by high rates of rehospitalization and mortality. Understanding symptom trajectories during this vulnerable phase is important for assessing patient outcomes. This study contributes to the limited evidence on post-discharge symptom evolution in heart failure patients.
Data Highlights
Symptom Trajectory Group
Odds Ratio for MACEs
Persistently Declining
2.242 (95% CI: 1.073–4.718, P = 0.032)
Stable-Moderate
Reference
Key Findings
207 patients (18.7%) experienced major adverse cardiovascular events (MACEs) during follow-up.
Four distinct symptom trajectory groups were identified: persistently declining, slowly improving, stable-moderate, and stable-high.
Patients in the persistently declining group had significantly higher odds of MACEs compared to the stable-moderate group.
The exploratory mediation analysis indicated a significant indirect association between KCCQ scores and MACEs through trajectory patterns.
Symptom recovery post-HF hospitalization was heterogeneous, with varying implications for cardiovascular outcomes.
Clinical Implications
The study provides insights into symptom trajectories using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and their association with cardiovascular risks.
Conclusion
The study emphasizes the importance of understanding symptom trajectories in predicting cardiovascular outcomes in heart failure patients during the vulnerable post-discharge phase.
