Abstract
BACKGROUND: Information about health-related quality of life (HRQOL) among caregivers of older patients with heart failure who receive heart transplantation (HT) and mechanical circulatory support (MCS) is sparse. We describe differences and factors associated with change in HRQOL before and early post-surgery among caregivers of older heart failure patients who underwent 3 surgical therapies: HT with pretransplant MCS (HT MCS), HT without pretransplant MCS (HT non-MCS), and long-term MCS. METHODS: Caregivers of older patients (60-80 years) from 13 US sites completed the EQ-5D-3 L visual analog scale (0 [worst]-100 [best] imaginable health state) and dimensions before and 3 and 6 months post-surgery. Analyses included linear regression, t tests, and nonparametric tests. RESULTS: Among 227 caregivers (HT MCS=54, HT non-MCS=76, long-term MCS=97; median age 62.7 years, 30% male, 84% White, 83% spouse/partner), EQ-5D visual analog scale scores were high before (84.8±14.1) and at 3 (84.7±13.0) and 6 (83.9±14.7) months post-surgery, without significant differences among groups or changes over time. Patient pulmonary hypertension presurgery (β=-13.72 [95% CI, -21.07 to -6.36]; P<0.001) and arrhythmia from 3 to 6 months post-operatively (β=-14.22 [95% CI, -27.41 to -1.02]; P=0.035) were associated with the largest decrements in caregiver HRQOL; patient marital/partner status (β=6.21 [95% CI, 1.34-11.08]; P=0.013) and presurgery coronary disease (β=8.98 [95% CI, 4.07-13.89]; P<0.001) were associated with the largest improvements. CONCLUSIONS: Caregivers of older patients undergoing heart failure surgeries reported overall high HRQOL before and early post-surgery. Understanding factors associated with caregiver HRQOL may inform decision-making and support needs. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02568930.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e010038 |
| Journal | Circulation: Heart Failure |
| Volume | 16 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2023 |
Funding
Dr Jane received grant support from the American Heart Association and the National Institutes of Health; is a consultant for Amgen, Abbott, Abiomed, and Novartis; and is on the advisory board of Abiomed and Cytokinetics. Dr Kao participated in the advisory board for CareDx and Bioventrix. Dr Spertus is a consultant at Amgen, Novartis, Bayer, Myokardia, and Janssen; on the scientific advisory board of United HealthCare; on the board of directors of BlueCross BlueShield, Kansas City; and is the copyright holder to the Kansas City Cardiomyopathy Questionnaire. Dr Yancy received spousal employment from Abbott Labs Inc. Dr Petty received speaking honorarium from Abbott Inc. M. Murray is a consultant on a research project at GE Healthcare. Dr Silvestry is a consultant at Abiomed, Medtronic, Syncardia, and Abbott. Dr Kirklin is a director of the DCC for STS INTERMACS; and received grant support from the National Institutes of Health/National Institute on Aging. Dr Grady is a consultant at Amgen Inc; is a paid lecturer for the American Heart Association; and received grant support from the National Institutes of Health (National Institute on Aging and National Heart, Lung, and Blood Institute). This work was sponsored by the National Institutes of Health, National Institute on Aging, SUSTAIN-IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Circulatory Support?; 01AG047416, Dr Grady [principal investigator]); ClinicalTrials.gov Unique Identifier: NCT02568930.
Keywords
- aged
- caregivers
- heart failure
- heart-assist devices
- quality of life
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine