Following PCI, patients with diabetes mellitus had significantly smaller improvements in physical quality of life at 12 months compared to those without diabetes.
Cohort (n=3,417)
Yes
Does the presence of diabetes mellitus affect quality of life trajectories over 12 months in patients after percutaneous coronary intervention?
Patients with and without diabetes mellitus experience similar overall improvements in quality of life up to 12 months after PCI, though physical improvements may be slightly attenuated in those with diabetes.
Abstract Background Comorbidity tends to be the rule and not the exception among patients with coronary artery disease (CAD), with diabetes mellitus (DM) being one of the most frequently associated conditions. Comorbid conditions complicate management and negatively affect health outcomes and quality of life (QoL). However, the impact of DM and CAD on QoL remains underexplored. Purpose To determine changes in QoL in patients with and without DM treated with percutaneous coronary intervention (PCI), from the index admission to 2-, 6- and 12 months after hospital discharge. Methods CONCARDPCI, a prospective multicentre cohort study including patients after PCI (N=3417). Of these, 621 had DM. Sociodemographic characteristics were self-reported at baseline. QoL was assessed using the RAND-12 Item Short Form Health Survey (RAND-12) across all timepoints and the Myocardial Infarction Dimensional Assessment Scale (MIDAS) at all follow-ups. For RAND-12, eight physical and mental health domains are summarised in a mental (MCS) and physical (PCS) component summary score. Associations between patients with and without DM were adjusted for age, sex, educational level, smoking status, alcohol consumption and physical activity assessed at baseline (Figure 1 and 2). All follow-up timepoints were modelled using generalised linear models for repeated measures, with patient and country fitted as random factors. Results Mean age was 66 years (SD 11, range 20-96), and 78% were men. Age and sex did not differ according to DM status. Most patients were native born; however, a statistically significantly larger proportion of patients with DM had an immigrant background, compared to patients without DM (7% vs. 4%). For RAND-12, MCS improved significantly over time, with no differences between the groups. PCS also improved significantly over time in both groups; however, the improvement was significantly smaller for patients with DM at 12 months. There was a significant improvement from 2 to 6 months in the MIDAS total score, with no difference between the groups. Further, the groups did not differ on any MIDAS domain scores. For MIDAS physical, scores improved significantly from 2 to 12 months for both groups. For MIDAS insecurity, both groups improved from 2 to 6 months but returned to the 2-month levels by 12 months. For MIDAS dependency and MIDAS emotional, both groups improved from 2 to 12 months. For MIDAS concerns, all patients improved from 2 to 12 months, with significantly greater improvements among the patients with DM at 6- (p=0.023) and 12 months (p=0.002). Conclusion All patients reported higher QoL over time after PCI, with no differences between the patients with and without DM; however, patients with DM had less improvements over time for PCS. There were no differences between patients with and without DM in MIDAS scores, except in the concerns domain, where patients with DM reported a statistically significant larger positive change at both 6 and 12 months.
Kjoelseth et al. (Wed,) conducted a cohort in Coronary artery disease post-PCI (n=3,417). Diabetes mellitus vs. Without diabetes mellitus was evaluated on Changes in quality of life (RAND-12 and MIDAS scores). Following PCI, patients with diabetes mellitus had significantly smaller improvements in physical quality of life at 12 months compared to those without diabetes.