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Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction.
Nicolau, José C; Brieger, David; Owen, Ruth; Furtado, Remo H M; Goodman, Shaun G; Cohen, Mauricio G; Simon, Tabassome; Westermann, Dirk; Granger, Christopher B; Grieve, Richard; Yasuda, Satoshi; Chen, Jiyan; Hedman, Katarina; Mellström, Carl; Brandrup-Wognsen, Gunnar; Pocock, Stuart J.
Afiliação
  • Nicolau JC; Instituto do Coração (InCor), Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
  • Brieger D; Concord Hospital and University of Sydney, Sydney, Australia.
  • Owen R; London School of Hygiene and Tropical Medicine, London, UK.
  • Furtado RHM; Instituto do Coração (InCor), Hospital das Clinicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
  • Goodman SG; Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Cohen MG; Terrence Donnelly Heart Centre, St Michael's Hospital, University of Toronto, Toronto, Canada.
  • Simon T; University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Westermann D; Department of Clinical Pharmacology and Clinical Research Platform of East of Paris, Assistance Publique-Hopitaux de Paris (APHP), Paris, France.
  • Granger CB; Sorbonne-Université (UPMC-Paris 06), Paris, France.
  • Grieve R; Department of General and Interventional Cardiology, University Heart Center Eppendorf, Hamburg, Germany.
  • Yasuda S; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Lübeck/Kiel, Hamburg, Germany.
  • Chen J; Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.
  • Hedman K; London School of Hygiene and Tropical Medicine, London, UK.
  • Mellström C; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Brandrup-Wognsen G; Guangdong General Hospital, Provincial Key Laboratory of Coronary Disease, Guangzhou, China.
  • Pocock SJ; AstraZeneca, Gothenburg, Sweden.
Clin Cardiol ; 43(12): 1352-1361, 2020 Dec.
Article em En | MEDLINE | ID: mdl-33146924
BACKGROUND: Diabetes mellitus (DM) is associated with increased cardiovascular (CV) risk. We compared health-related quality of life (HRQoL), healthcare resource utilization (HRU), and clinical outcomes of stable post-myocardial infarction (MI) patients with and without DM. HYPOTHESIS: In post-MI patients, DM is associated with worse HRQoL, increased HRU, and worse clinical outcomes. METHODS: The prospective, observational long-term risk, clinical management, and healthcare Resource utilization of stable coronary artery disease study obtained data from 8968 patients aged ≥50 years 1 to 3 years post-MI (369 centers; 25 countries). Patients with ≥1 of the following risk factors were included: age ≥65 years, history of a second MI >1 year before enrollment, multivessel coronary artery disease, creatinine clearance ≥15 and <60 mL/min, and DM treated with medication. Self-reported health status was assessed at baseline, 1 and 2 years and converted to EQ-5D scores. The main outcome measures were baseline HRQoL and HRU during follow-up. RESULTS: DM at enrollment was 33% (2959 patients, 869 insulin treated). Mean baseline EQ-5D score (0.86 vs 0.82; P < .0001) was higher; mean number of hospitalizations (0.38 vs 0.50, P < .0001) and mean length of stay (LoS; 9.3 vs 11.5; P = .001) were lower in patients without vs with DM. All-cause death and the composite of CV death, MI, and stroke were significantly higher in DM patients, with adjusted 2-year rate ratios of 1.43 (P < .01) and 1.55 (P < .001), respectively. CONCLUSIONS: Stable post-MI patients with DM (especially insulin treated) had poorer EQ-5D scores, higher hospitalization rates and LoS, and worse clinical outcomes vs those without DM. Strategies focusing specifically on this high-risk population should be developed to improve outcomes. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01866904 (https://clinicaltrials.gov).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Nível de Saúde / Diabetes Mellitus / Autorrelato / Recursos em Saúde / Infarto do Miocárdio Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Patient_preference Limite: Aged / Female / Humans / Male Idioma: En Revista: Clin Cardiol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Nível de Saúde / Diabetes Mellitus / Autorrelato / Recursos em Saúde / Infarto do Miocárdio Tipo de estudo: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Patient_preference Limite: Aged / Female / Humans / Male Idioma: En Revista: Clin Cardiol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos