Trajectories of symptom scores and risk of cardiovascular events in the vulnerable phase of heart failure: an analysis using a latent class trajectory model - Summary - 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
To characterize symptom trajectories post-heart failure discharge and their association with early cardiovascular events.
Approach:
Study Design: Prospective cohort study involving 1,109 patients with chronic heart failure, assessing symptoms at six time points using the Kansas City Cardiomyopathy Questionnaire (KCCQ).
Data Analysis: Latent class trajectory modeling was used to identify symptom trajectory groups, and multivariable logistic regression analyzed associations with major adverse cardiovascular events (MACEs).
Key Findings:
18.7% of patients experienced 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 higher odds of MACEs (OR = 2.242, 95% CI: 1.073–4.718, P = 0.032) compared to the stable-moderate group.
An exploratory mediation analysis indicated a significant indirect association between KCCQ scores and MACEs through trajectory patterns (β=–0.007, P < 0.001).
Interpretation:
Limitations:
The study is limited to a specific cohort in China, which may affect generalizability.
Potential biases in self-reported symptom assessments.
