Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden.
Diab Vasc Dis Res. 2013 Jul;10(4):361-7. doi: 10.1177/1479164113482694. Epub 2013 May 14.
The Diabetes mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction (DIGAMI) 2 Quality of Life (QoL) sub-study included 465 patients with type 2 diabetes and acute myocardial infarction (AMI) followed for 2 years. Self-rated health was reported by the rating scale (RS), graded 0 = death to 100 = perfect health. Prospective associations between RS and all-cause mortality, cardiovascular (CV) death and cardiovascular events (CVEs = CV death, non-fatal AMI, stroke) were assessed. Median age was 68 years (range 59-74), 68% male. Patients experiencing CVE (n = 132) or death (n = 71) had lower RS compared with patients free from events: 60 (50-79) versus 70 (55-81) (p < 0.001) and 60 (50-75) versus 70 (51-80) (p = 0.008). The RS score predicted CVE [hazard ratio (HR); 95% confidence interval (CI): 0.87; 0.80-0.95] and all-cause mortality (0.86; 0.76-0.97), and corresponding HRs after adjustment were 0.90; 0.83-0.99 and 0.90; 0.79-1.02, respectively. A low self-rated health is of prognostic importance in patients with type 2 diabetes and AMI and may serve as an easily obtainable indicator of high risk for CVEs supplementing traditional risk factors.
糖尿病胰岛素-葡萄糖输注治疗急性心肌梗死（DIGAMI）2 生活质量（QoL）子研究纳入了 465 例 2 型糖尿病合并急性心肌梗死（AMI）的患者，随访时间为 2 年。健康自评采用评分量表（RS）进行报告，评分范围为 0=死亡至 100=完美健康。评估 RS 与全因死亡率、心血管（CV）死亡率和心血管事件（CVEs=CV 死亡、非致命性 AMI、中风）之间的前瞻性关联。中位年龄为 68 岁（范围 59-74 岁），68%为男性。发生 CVEs（n=132）或死亡（n=71）的患者 RS 评分低于无事件患者：60（50-79）与 70（55-81）（p<0.001）和 60（50-75）与 70（51-80）（p=0.008）。RS 评分预测 CVEs[风险比（HR）；95%置信区间（CI）：0.87；0.80-0.95]和全因死亡率（0.86；0.76-0.97），调整后相应的 HR 分别为 0.90；0.83-0.99 和 0.90；0.79-1.02。低自我报告健康状况在 2 型糖尿病合并 AMI 的患者中具有预后意义，可作为一种易于获得的 CVEs 高危指标，补充传统危险因素。
