A health perception score predicts cardiac events in patients with heart failure: Results from the IMPRESS trial

Background: New York Heart Association (NYHA) class and treadmill exercise test variables are widely used for estimating prognosis and measuring the o utcomes of treatment in patients with heart failure, but they do not take p atients' perceptions into account. Methods and Results: Five hundred forty-five patients enrolled in a multice nter 24-week comparison of the effects of omapatrilat and lisinopril on fun ctional capacity in patients with heart failure reported a visual analog sc ale (VAS) score of their overall health perception at week 12 of the study. A total of 27 first events, defined as death or worsening heart failure (h ospitalization, emergency room visit, or study discontinuation), occurred i n the subsequent 12 weeks. The mean (+/-SD) health perception scores were 0 .43 +/- 0.31 and 0.68 +/- 0.20 in patients with and without, events, respec tively (P = .0006). The risk ratio (RR) for an event associated with a deci le change in the health perception score was 0.74 (95% confidence interval [CI], 0.61-0.88; P = .001). The RR was unaltered by adjustment for demograp hic variables, treadmill time, and NYHA functional class. Although the week 12 NYHA functional class was predictive of events (RR = 2.1; 95% CI, 1.2-4 .6; P = .04), treadmill time was not (RR = 0.87; 95% CI, 0.73-1.03; P = 0.1 1). Conclusions: A patient-reported measure of perceived health predicts events in patients with heart failure.