title: Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention.
abstract: We examined the impact of co-occurring diabetes and hopelessness on 3-year prognosis in percutaneous coronary intervention patients. Consecutive patients (n = 534) treated with the paclitaxel-eluting stent completed a set of questionnaires at baseline and were followed up for 3-year adverse clinical events. The incidence of 3-year death/non-fatal myocardial infarction was 3.5% in patients with no risk factors (neither hopelessness nor diabetes), 8.2% in patients with diabetes, 11.2% in patients with high hopelessness, and 15.9% in patients with both factors (p = 0.001). Patients with hopelessness (HR: 3.28; 95% CI: 1.49-7.23) and co-occurring diabetes and hopelessness (HR: 4.89; 95% CI: 1.86-12.85) were at increased risk of 3-year adverse clinical events compared to patients with no risk factors, whereas patients with diabetes were at a clinically relevant but not statistically significant risk (HR: 2.40; 95% CI: 0.82-7.01). These results remained, adjusting for baseline characteristics and depressive symptoms. These findings testify to the importance of identifying patients with co-occurring risk factors, as they likely require special management in clinical practice in addition to standard medical treatment.
authors.affiliation: Department of Medical Psychology, CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Room P506, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands. s.s.pedersen@uvt.nl
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Ruud A M
authors.initials: RA
authors.lastname: Erdman
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000523:psychology*; D003863:Depression; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors