[Quality of life in diabetic patients with coronary artery disease treated with percutaneous coronary angioplasty].
Increased restenosis rate, higher incidence of coronary events, and, in some studies also increased mortality are observed during long-term follow-up in patients (pts) with diabetes mellitus treated with percutaneous coronary angioplasty. This is why some authors suggest that indications for PTCA in the group of diabetic pts should be significantly limited. The aim of our study was the estimation of clinical condition and quality of life in diabetic patients who underwent PTCA procedure in order to establish indications for percutaneous revascularisation in this group of pts. The study group consisted of 54 diabetic patients who were successfully treated with percutaneous coronary angioplasty in the period of 1987-1996. All pts were assessed clinically and quality of life was estimated on the basis of specially designed questionnaire. During mean 5-year follow-up 1(1.9%) patient died, 2 (3.7%) pts had acute myocardial infarction, restenosis was diagnosed in 25 (46.3%) pts. Repeated revascularisation was necessary in 27 (50%) pts. Significant clinical improvement was observed in the pts from the study group as compared to their clinical condition before the procedure (CCS 0 or I--61% vs 0%, p < 0.0001, III--9% vs. 39%, p < 0.0003, IV--1.9% vs. 22%, p < 0.001). The rate of pts who were employed did not change in consequence of successful PTCA procedure. The number of pts returning to work was equal to the number of patients receiving social benefits. Subjective improvement was declared by 87% of pts. Lack of angina pectoris episodes was reported by 52% of pts and in 35% of pts the number of angina pectoris episodes was significantly reduced. Better tolerance of physical activity was declared by 59% of pts, and 65% of the studied pts fully came back to their non-professional activities. Partial return to non-professional activities was possible for 24% of pts. Normal sexual activity was declared by 65% of pts. Only 9% of the studied pts experienced significant limitation in their sexual activity. PTCA met the expectations of 89% of pts while the number of negative opinions, i.e. the lack of subjective improvement, impaired quality of life, or disappointment with the results of the PTCA procedure did not exceed 13%. Significantly worse results of the selected parameters describing the quality of life were observed in the group of diabetic pts treated with insulin.


CONCLUSIONS
PTCA improved quality of life in 60-90% of pts with diabetes mellitus, nevertheless, did not affect the employment status of successfully treated pts. Patients who needed insulin therapy had worse indicators of life quality, however thorough analysis suggest that PTCA can be advised as a method of treatment in the group of diabetic patients with coronary artery disease.
Przewłocki
T
T
Klinika Chorób Serca i Naczyń, Instytutu Kardiologii Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Podolec
P
P
Tracz
W
W
Syty
M
M
Piatek
J
J
Ryniewicz
W
W
Pasowicz
M
M
Goncerz
G
G
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003327:Coronary Disease / Q000150:complications* / Q000628:therapy*; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life