Association between treatment-induced changes in the Kansas City Cardiomyopathy Questionnaire and clinical outcomes in chronic heart failure: a trial-level meta-regression analysis

Treatment-induced changes in KCCQ scores are significantly correlated with clinical outcomes in phase 3 HF trials. These findings support KCCQ as a promising candidate intermediate endpoint that provides supportive evidence for the clinical benefit of HF therapies. However, our results remain hypothesis-generating, and further validation using individual patient data and cross-mechanism studies is warranted before KCCQ can be formally established as a regulatory surrogate endpoint.