Abstract 9364: Caregiver Anxiety Significantly Reduced from Baseline to 24 Months After Surgery: Findings from the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Circulatory Support ( Sustain-it) Study

Abstract

Introduction: We previously reported higher health-related quality of life (HRQOL), lower depression scores, and decreased anxiety in caregivers (CGs) of older (60-80 years) heart failure (HF) patients (PTs) treated with destination therapy mechanical circulatory support (DT MCS) or heart transplantation (HT) from baseline (before surgery) to 12 months post-surgery. We expand the analysis of CGs’ HRQOL and symptoms of depression and anxiety through 24-months post-surgery. Methods: From 10/1/15-12/31/18, 13 U.S. centers enrolled 301 CGs of HF PTs: 193 awaiting HT (92 with MCS, 101 without MCS) and 108 DT MCS. At baseline and 24-months post-surgery, CGs completed the following instruments: EQ-5D-3L (Visual Analog Scale [VAS]: 0 [worst]-100 [best] imaginable health state); PHQ-8 (range=0-24; score > 10=current depressive symptoms); and STAI-State (range=20-80, higher score=more anxiety). Analyses included paired t-tests and baseline-adjusted linear regression. Results: CGs average age was 60.9±10 years, 85% were Caucasian, 85% female, and 83% spouses. No significant differences in HRQOL and depressive symptoms were found between groups at baseline, nor were significant changes observed between baseline and 24-months within any group. At baseline, anxiety was higher for CGs of DT MCS PTs compared to CGs of HT MCS (p=0.026) and HT non-MCS PTs (p<0.001; Figure). Between baseline and 24-months, STAI-State total scores were reduced among DT MCS and HT Non-MCS CGs (p=0.019 and p=0.001, respectively), but not among HT MCS CGs (p=0.86). At 24 months, significant between-group differences were observed in all scales: HRQOL was highest in HT non-MCS, depressive symptoms and anxiety highest in HT MCS CGs. Conclusions: Recognizing the impact of HT and DT MCS on CGs of older HF PTs may allow clinicians to provide targeted support to CGs, especially related to anxiety. These findings also may inform PT and CG decision making when considering surgical treatments for HF.