Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction
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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.
In: CLIN CARDIOL, Vol. 43, No. 12, 12.2020, p. 1352-1361.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction
AU - Nicolau, José C
AU - Brieger, David
AU - Owen, Ruth
AU - Furtado, Remo H M
AU - Goodman, Shaun G
AU - Cohen, Mauricio G
AU - Simon, Tabassome
AU - Westermann, Dirk
AU - Granger, Christopher B
AU - Grieve, Richard
AU - Yasuda, Satoshi
AU - Chen, Jiyan
AU - Hedman, Katarina
AU - Mellström, Carl
AU - Brandrup-Wognsen, Gunnar
AU - Pocock, Stuart J
N1 - © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
PY - 2020/12
Y1 - 2020/12
N2 - 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).
AB - 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).
KW - Aged
KW - Diabetes Mellitus/economics
KW - Female
KW - Follow-Up Studies
KW - Health Resources/statistics & numerical data
KW - Health Status
KW - Humans
KW - Male
KW - Myocardial Infarction/economics
KW - Prognosis
KW - Prospective Studies
KW - Quality of Life
KW - Risk Factors
KW - Self Report
KW - Time Factors
U2 - 10.1002/clc.23476
DO - 10.1002/clc.23476
M3 - SCORING: Journal article
C2 - 33146924
VL - 43
SP - 1352
EP - 1361
JO - CLIN CARDIOL
JF - CLIN CARDIOL
SN - 0160-9289
IS - 12
ER -
