Peterson Pamela N, Spertus John A, Magid David J, Masoudi Fredrick A, Reid Kimberly, Hamman Richard F, Rumsfeld John S
Department of Medicine, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA.
BMC Cardiovasc Disord. 2006 Oct 24;6:41. doi: 10.1186/1471-2261-6-41.
Diabetes is an important predictor of mortality patients with ACS. However, little is known about the association between diabetes and health status after ACS. The objective of this study was to examine the association between diabetes and patients' health status outcomes one year after an acute coronary syndrome (ACS).
This was a prospective cohort study of patients hospitalized with ACS. Patients were evaluated at baseline and one year with the Seattle Angina Questionnaire (SAQ). Socio-demographic and clinical characteristics were ascertained during index ACS hospitalization. One year SAQ Angina Frequency, Physical Limitation, and Health-Related Quality of Life (HRQoL) scales were the primary outcomes of the study.
Of 1199 patients, 326 (37%) had diabetes. Patients with diabetes were more likely to present with unstable angina (52% vs. 40%; p < 0.001), less likely to present with STEMI (20% vs. 31%; p < 0.001), and less likely to undergo coronary angiography (68% vs. 82%; p < 0.001). In multivariable analyses, the presence of diabetes was associated with significantly more angina (OR 1.36; 95% CI 1.01-1.38), cardiac-related physical limitation (OR 1.94; 95% CI 1.57-3.24) and HRQoL deficits (OR 1.43; 95% CI 1.01-2.04) at one year.
Diabetes is associated with more angina, worse physical limitation, and worse HRQoL one year after an ACS. Future studies should assess whether health status outcomes of patients with diabetes could be improved through more aggressive ACS treatment or post-discharge surveillance and angina management.
糖尿病是急性冠状动脉综合征（ACS）患者死亡率的重要预测因素。然而，关于糖尿病与ACS后健康状况之间的关联却知之甚少。本研究的目的是探讨糖尿病与急性冠状动脉综合征（ACS）后一年患者健康状况结局之间的关联。
这是一项对因ACS住院患者的前瞻性队列研究。患者在基线时和一年后使用西雅图心绞痛问卷（SAQ）进行评估。在首次ACS住院期间确定社会人口统计学和临床特征。研究的主要结局是一年后的SAQ心绞痛频率、身体限制和健康相关生活质量（HRQoL）量表。
在1199例患者中，326例（37%）患有糖尿病。糖尿病患者更易出现不稳定型心绞痛（52%对40%；p<0.001），较少出现ST段抬高型心肌梗死（STEMI，20%对31%；p<0.001），且接受冠状动脉造影的可能性较小（68%对82%；p<0.001）。在多变量分析中，糖尿病的存在与一年时显著更多的心绞痛（OR 1.36；95%CI 1.01 - 1.38）、心脏相关身体限制（OR 1.94；95%CI 1.57 - 3.24）和HRQoL缺陷（OR 1.43；95%CI 1.01 - 2.04）相关。
糖尿病与ACS后一年更多的心绞痛、更差的身体限制和更差的HRQoL相关。未来的研究应评估是否可以通过更积极的ACS治疗或出院后监测及心绞痛管理来改善糖尿病患者的健康状况结局。
