Relation of Angina Pectoris to Outcomes, Quality of Life, and Response to Exercise Training in Patients With Chronic Heart Failure (from HF-ACTION)

Kishan S. Parikh, Adrian Coles, Phillip J. Schulte, William E. Kraus, Jerome L. Fleg, Steven J. Keteyian, Ileana L. Pina, Mona Fiuzat, David J. Whellan, Christopher M. O'Connor, Robert J. Mentz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Angina pectoris (AP) is associated with worse outcomes in heart failure (HF). We investigated the association of AP with health-related quality of life (HRQoL), exercise capacity, and clinical outcomes and its interaction with exercise training in an HF population. We grouped 2,331 patients with HF with reduced ejection fraction in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) trial of usual care ± exercise training according to whether they had self-reported AP by Canadian classification score. HRQoL and clinical outcomes were assessed by AP status. In HF-ACTION, 406 patients (17%) had AP at baseline (44% with Canadian classification score ≥II) with HF severity similar to those without AP. Patients with AP had similar baseline exercise capacity but worse depressive symptoms and HRQoL. AP was associated with 22% greater adjusted risk for all-cause mortality/hospitalizations, driven by hospitalizations. There was significant interaction between baseline AP and exercise training peak VO2 change (p = 0.019) but not other end points. Exercise training was associated with greater peak VO2 improvement after 3 months in patients with AP (treatment effect = 1.25 ml/kg/min, 95% CI 0.6 to 1.9). In conclusion, AP was associated with worse HRQoL and depressive symptoms. Despite greater peak VO2 improvement with exercise training, patients with AP experienced more adverse outcomes.

Original languageEnglish (US)
Pages (from-to)1211-1216
Number of pages6
JournalAmerican Journal of Cardiology
Volume118
Issue number8
DOIs
StatePublished - Oct 15 2016

Fingerprint

Angina Pectoris
Heart Failure
Quality of Life
Exercise
Hospitalization
Depression

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relation of Angina Pectoris to Outcomes, Quality of Life, and Response to Exercise Training in Patients With Chronic Heart Failure (from HF-ACTION). / Parikh, Kishan S.; Coles, Adrian; Schulte, Phillip J.; Kraus, William E.; Fleg, Jerome L.; Keteyian, Steven J.; Pina, Ileana L.; Fiuzat, Mona; Whellan, David J.; O'Connor, Christopher M.; Mentz, Robert J.

In: American Journal of Cardiology, Vol. 118, No. 8, 15.10.2016, p. 1211-1216.

Research output: Contribution to journalArticle

Parikh, KS, Coles, A, Schulte, PJ, Kraus, WE, Fleg, JL, Keteyian, SJ, Pina, IL, Fiuzat, M, Whellan, DJ, O'Connor, CM & Mentz, RJ 2016, 'Relation of Angina Pectoris to Outcomes, Quality of Life, and Response to Exercise Training in Patients With Chronic Heart Failure (from HF-ACTION)', American Journal of Cardiology, vol. 118, no. 8, pp. 1211-1216. https://doi.org/10.1016/j.amjcard.2016.07.040
Parikh, Kishan S. ; Coles, Adrian ; Schulte, Phillip J. ; Kraus, William E. ; Fleg, Jerome L. ; Keteyian, Steven J. ; Pina, Ileana L. ; Fiuzat, Mona ; Whellan, David J. ; O'Connor, Christopher M. ; Mentz, Robert J. / Relation of Angina Pectoris to Outcomes, Quality of Life, and Response to Exercise Training in Patients With Chronic Heart Failure (from HF-ACTION). In: American Journal of Cardiology. 2016 ; Vol. 118, No. 8. pp. 1211-1216.
@article{198f930668a746e2a1fcd79989356dc0,
title = "Relation of Angina Pectoris to Outcomes, Quality of Life, and Response to Exercise Training in Patients With Chronic Heart Failure (from HF-ACTION)",
abstract = "Angina pectoris (AP) is associated with worse outcomes in heart failure (HF). We investigated the association of AP with health-related quality of life (HRQoL), exercise capacity, and clinical outcomes and its interaction with exercise training in an HF population. We grouped 2,331 patients with HF with reduced ejection fraction in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) trial of usual care ± exercise training according to whether they had self-reported AP by Canadian classification score. HRQoL and clinical outcomes were assessed by AP status. In HF-ACTION, 406 patients (17{\%}) had AP at baseline (44{\%} with Canadian classification score ≥II) with HF severity similar to those without AP. Patients with AP had similar baseline exercise capacity but worse depressive symptoms and HRQoL. AP was associated with 22{\%} greater adjusted risk for all-cause mortality/hospitalizations, driven by hospitalizations. There was significant interaction between baseline AP and exercise training peak VO2 change (p = 0.019) but not other end points. Exercise training was associated with greater peak VO2 improvement after 3 months in patients with AP (treatment effect = 1.25 ml/kg/min, 95{\%} CI 0.6 to 1.9). In conclusion, AP was associated with worse HRQoL and depressive symptoms. Despite greater peak VO2 improvement with exercise training, patients with AP experienced more adverse outcomes.",
author = "Parikh, {Kishan S.} and Adrian Coles and Schulte, {Phillip J.} and Kraus, {William E.} and Fleg, {Jerome L.} and Keteyian, {Steven J.} and Pina, {Ileana L.} and Mona Fiuzat and Whellan, {David J.} and O'Connor, {Christopher M.} and Mentz, {Robert J.}",
year = "2016",
month = "10",
day = "15",
doi = "10.1016/j.amjcard.2016.07.040",
language = "English (US)",
volume = "118",
pages = "1211--1216",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "8",

}

TY - JOUR

T1 - Relation of Angina Pectoris to Outcomes, Quality of Life, and Response to Exercise Training in Patients With Chronic Heart Failure (from HF-ACTION)

AU - Parikh, Kishan S.

AU - Coles, Adrian

AU - Schulte, Phillip J.

AU - Kraus, William E.

AU - Fleg, Jerome L.

AU - Keteyian, Steven J.

AU - Pina, Ileana L.

AU - Fiuzat, Mona

AU - Whellan, David J.

AU - O'Connor, Christopher M.

AU - Mentz, Robert J.

PY - 2016/10/15

Y1 - 2016/10/15

N2 - Angina pectoris (AP) is associated with worse outcomes in heart failure (HF). We investigated the association of AP with health-related quality of life (HRQoL), exercise capacity, and clinical outcomes and its interaction with exercise training in an HF population. We grouped 2,331 patients with HF with reduced ejection fraction in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) trial of usual care ± exercise training according to whether they had self-reported AP by Canadian classification score. HRQoL and clinical outcomes were assessed by AP status. In HF-ACTION, 406 patients (17%) had AP at baseline (44% with Canadian classification score ≥II) with HF severity similar to those without AP. Patients with AP had similar baseline exercise capacity but worse depressive symptoms and HRQoL. AP was associated with 22% greater adjusted risk for all-cause mortality/hospitalizations, driven by hospitalizations. There was significant interaction between baseline AP and exercise training peak VO2 change (p = 0.019) but not other end points. Exercise training was associated with greater peak VO2 improvement after 3 months in patients with AP (treatment effect = 1.25 ml/kg/min, 95% CI 0.6 to 1.9). In conclusion, AP was associated with worse HRQoL and depressive symptoms. Despite greater peak VO2 improvement with exercise training, patients with AP experienced more adverse outcomes.

AB - Angina pectoris (AP) is associated with worse outcomes in heart failure (HF). We investigated the association of AP with health-related quality of life (HRQoL), exercise capacity, and clinical outcomes and its interaction with exercise training in an HF population. We grouped 2,331 patients with HF with reduced ejection fraction in the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION) trial of usual care ± exercise training according to whether they had self-reported AP by Canadian classification score. HRQoL and clinical outcomes were assessed by AP status. In HF-ACTION, 406 patients (17%) had AP at baseline (44% with Canadian classification score ≥II) with HF severity similar to those without AP. Patients with AP had similar baseline exercise capacity but worse depressive symptoms and HRQoL. AP was associated with 22% greater adjusted risk for all-cause mortality/hospitalizations, driven by hospitalizations. There was significant interaction between baseline AP and exercise training peak VO2 change (p = 0.019) but not other end points. Exercise training was associated with greater peak VO2 improvement after 3 months in patients with AP (treatment effect = 1.25 ml/kg/min, 95% CI 0.6 to 1.9). In conclusion, AP was associated with worse HRQoL and depressive symptoms. Despite greater peak VO2 improvement with exercise training, patients with AP experienced more adverse outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84995785031&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995785031&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2016.07.040

DO - 10.1016/j.amjcard.2016.07.040

M3 - Article

VL - 118

SP - 1211

EP - 1216

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 8

ER -