The impact of diabetes on one-year health status outcomes following acute coronary syndromes.
BACKGROUND
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).


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Peterson
Pamela N
PN
Department of Medicine, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA. Pamela.Peterson@uchsc.edu
Spertus
John A
JA
Magid
David J
DJ
Masoudi
Fredrick A
FA
Reid
Kimberly
K
Hamman
Richard F
RF
Rumsfeld
John S
JS
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D010807:Physical Endurance; D011446:Prospective Studies; D011788:Quality of Life; D013577:Syndrome; D013997:Time Factors