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Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction.

ABSTRACT: 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?
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).

SUBMITTER: Nicolau JC

PROVIDER: S-EPMC7724227 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction.

Nicolau José C JC Brieger David D Owen Ruth R Furtado Remo H M RHM Goodman Shaun G SG Cohen Mauricio G MG Simon Tabassome T Westermann Dirk D Granger Christopher B CB Grieve Richard R Yasuda Satoshi S Chen Jiyan J Hedman Katarina K Mellström Carl C Brandrup-Wognsen Gunnar G Pocock Stuart J SJ

Clinical cardiology 20201104 12

<h4>Background</h4>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.<h4>Hypothesis</h4>In post-MI patients, DM is associated with worse HRQoL, increased HRU, and worse clinical outcomes.<h4>Methods</h4>The prospective, observational long-term risk, clinical management, and healthcare Re ...[more]

PMID: 33146924

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Project description:BackgroundType 2 diabetes leads to an increase in the prevalence of lipid abnormalities, which increases the risk of cardiovascular disease. Therefore, current guidelines generally recommend the use of moderate or high-intensity statins in patients with type 2 diabetes. There are still few studies on the overall risk benefit balance of statins for acute myocardial infarction (AMI) patients with diabetes. Compared with other types of lipid-lowering drugs, the advantage of statins for the prognosis of patients with AMI has not yet been determined. We investigated the effects of statins and non-statins on intensive care unit (ICU) and inpatient mortality in patients with AMI and diabetes.MethodsThis study retrospectively collected all patients with AMI and diabetes in the Medical Information Mart Intensive Care-IV database. We assessed ICU and in-hospital mortality rates during hospitalization in both groups. The clinical end point was in-hospital mortality and ICU mortality. Kaplan-Meier and Cox proportional-hazards regression models were applied to analyze the correlation between the two groups and the outcomes.ResultsData on 1,315 patients with AMI and diabetes were collected, among which 1,211 used statins during hospitalization. The overall in-hospital mortality of patients with AMI and diabetes was 17.2%, and the total ICU mortality was 12.6%. The in-hospital mortality was lower for the statin group than for the non-statin group (13.9% and 55.8%, respectively). Kaplan-Meier survival curves demonstrated that survival probability was higher in the statin group than in the non-statin group. In the cohort without hyperlipidemia, the statin group had lower risks of ICU death (HR = 0.12, 95% CI = 0.04-0.40) and in-hospital death (HR = 0.36, 95% CI = 0.16-0.84) compared with the non-statin group.ConclusionsStatins can significantly reduce ICU and in-hospital mortality rates in patients with AMI and diabetes. Even in the population without hyperlipidemia, statins can still reduce the mortality in patients with AMI and diabetes.

Dataset Information

Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction.

Publications

Diabetes association with self-reported health, resource utilization, and prognosis post-myocardial infarction.

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