Research article

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

Pamela N Peterson^1,2 , John A Spertus^3,4* , David J Magid^5,6* , Fredrick A Masoudi^1,2* , Kimberly Reid^3* , Richard F Hamman^6* and John S Rumsfeld^7*

¹  Department of Medicine, University of Colorado at Denver and Health Sciences Center, Denver Colorado, USA

²  Department of Medicine, Denver Health Medical Center, Denver Colorado, USA

³  Cardiovascular Research, Mid America Heart Institute of Saint Luke's Hospital, Kansas City Missouri, USA

⁴  School of Medicine, University of Missouri – Kansas City, Kansas City Missouri, USA

⁵  Clinical Research Unit, Kaiser Permanente, Denver Colorado, USA

⁶  Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Denver Colorado, USA

⁷  Department of Medicine, VA Medical Center, Denver Colorado, USA

author email corresponding author email* Contributed equally

BMC Cardiovascular Disorders 2006, 6:41doi:10.1186/1471-2261-6-41

Published:	24 October 2006

Abstract

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.

Conclusion

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.