Prognostic value of estimating functional capacity with the use of the duke activity status index in stable patients with chronic heart failure

Justin L. Grodin, Muhammad Hammadah, Yiying Fan, Stanley L. Hazen, W. H.Wilson Tang

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background Over the years, several methods have been developed to reliably quantify functional capacity in patients with heart failure. Few studies have investigated the prognostic value of these assessment tools beyond cardiorenal prognostic biomarkers in stable patients with chronic heart failure.

Methods and Results We administered the Duke Activity Status Index (DASI) questionnaire, a self-assessment tool comprising 12 questions for estimating functional capacity, to 1,700 stable nonacute coronary syndrome patients with history of heart failure who underwent elective diagnostic coronary angiography with 5-year follow-up of all-cause mortality. In a subset of patients (n = 800), B-type natriuretic peptide (BNP) was measured. In our study cohort, the median DASI score was 26.2 (interquartile range [IQR] 15.5-42.7). Low DASI score provided independent prediction of a 3.3-fold increase in 5-year mortality risk (quartile 1 vs quartile 4: hazard ratio [HR] 3.33, 95% confidence interval [CI] 2.57-4.36; P <.0001). After adjusting for traditional risk factors, BNP, and estimated glomerular filtration rate, low DASI score still conferred a 2.6-fold increase in mortality risk (HR 2.57, 95% CI 1.64-4.15; P <.0001).

Conclusions A simple self-assessment tool of functional capacity provides independent and incremental prognostic value for mortality prediction in stable patients with chronic heart failure beyond cardiorenal biomarkers.

Original languageEnglish (US)
Pages (from-to)44-50
Number of pages7
JournalJournal of Cardiac Failure
Volume21
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

    Fingerprint

Keywords

  • Chronic heart failure
  • functional status
  • prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this