EQ-5D Utility Impact of Worsening NYHA Class and CV Hospitalization (CVH) on Health-Related Quality of Life (HRQoL) of Patients With ATTR-CM Based on the ATTRibute-CM Trial

Author(s)

Irina Proskorovsky, MSc1, Mira Krotneva, MSc2, Ágnes Benedict, MSc3, Maria Hülsebeck, MSc4, Heather Falvey, MSc5.
1Thermo Fisher Scientific, Valencia, Spain, 2Thermo Fisher Scientific, Ottawa, ON, Canada, 3Thermo Fisher Scientific, Vienna, Austria, 4Bayer AG, Berlin, Germany, 5BridgeBio Corp, San Mateo, CA, USA.
OBJECTIVES: Transthyretin (TTR) amyloid cardiomyopathy (ATTR-CM) leads to progressive heart failure indicated by worsening of NYHA class, increased cardiovascular hospitalizations (CVH), and impaired health-related quality of life (HRQoL). This study investigated the impact of disease progression measured by worsening of NYHA class and recent CVH on the HRQoL of ATTR-CM participants in the ATTRibute-CM trial over 30 months.
METHODS: EQ-5D-5L values (3561 observations) collected from 607 participants enrolled in ATTRibute-CM were mapped to the UK age- and sex-adjusted EQ-5D-3L utility values using the mapping function developed by the NICE Decision Support Unit. EQ-5D utility scores were analyzed using univariate and multivariate mixed-effects linear regression, with baseline and time-varying predictors. Covariates were trimmed from the multivariate regression model using backward selection with an exit p-value of >0.05. Disutility values from worsening NYHA class, the immediate impact of CVH and the time for HRQoL to recover to pre-hospitalization levels were estimated. NYHA I&II observations were pooled.
RESULTS: Final regression model indicated that being in NYHA III (591 observations) or NYHA IV (21 observations) was associated with a reduction in EQ-5D-3L of 0.0933 (SE: 0.0085, p<0.001) and 0.3031 (SE: 0.0362, p<0.001), respectively, compared to being in NYHA I-II (2,342 observations), irrespective of treatment. Recent CVH (in the past 1 month) was associated with 0.1451 (SE: 0.021, p<0.001) decrement in utility. Additionally, the analysis suggested that it may take up to four months for HRQoL to gradually recover after hospitalization.
CONCLUSIONS: Results demonstrate that among ATTR-CM patients, worsening NYHA class and recent CVH were associated with significant negative impact on HRQoL, measured by the EQ-5D, and provides essential information for researchers, patients and clinicians. Maintaining patients in lower NYHA class and preventing CVH may result in significant HRQoL gains for patients with ATTR-CM.

Conference/Value in Health Info

2025-11, ISPOR Europe 2025, Glasgow, Scotland

Value in Health, Volume 28, Issue S2

Code

CO100

Topic

Clinical Outcomes, Economic Evaluation, Patient-Centered Research

Topic Subcategory

Clinical Outcomes Assessment

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory)

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