Young adults with diabetes who experience an acute myocardial infarction (MI) tend to see significant health status improvements in the subsequent year and are not significantly worse off than patients who did not have diabetes at the time of acute MI, according to study results published in the Journal of the American Heart Association.
To evaluate the relationship between diabetes and health status in the 12 months after acute MI, researchers used data from 3501 adults (aged 18-55 years) with documented acute MI enrolled in the VIRGO study (ClinicalTrials.gov Identifier: NCT00597922). They assessed each patient using the Seattle Angina Questionnaire for disease-specific health status, the 12-item Short-Form Health Survey (SF-12) for general physical and mental functioning, and the EuroQol-5 Dimensions Visual Analogue Scale for general quality of life. Health status scores were collected at baseline hospitalization, at 1 month, and at 12 months after acute MI.
Overall, 42.6% of patients had diabetes at the time of acute MI. At baseline, compared with patients without diabetes, patients with diabetes had significantly worse Seattle Angina Questionnaire scores for angina frequency (86 vs 81, respectively; P <.0001), physical limitations (85 vs 77; P <.0001), and quality of life (57 vs 55; P =.0106); SF-12 scores for mental (46 vs 44; P <.0001) and physical functioning (46 vs 41; P <.0001); and EuroQol-5 Dimensions Visual Analogue Scale score (66 vs 61; P <.0001).
In the year after acute MI, both groups significantly improved on most health status scores. In fact, across 12 months, the between-group differences gradually narrowed in all but physical functioning score on the SF-12 survey.
Using linear-mixed effects models adjusted for sociodemographic factors, acute MI treatment, cardiovascular risk factors, clinical characteristics, comorbidities, psychosocial factors, and healthcare use, the researchers found that regardless of sex, patients with diabetes tended to have poorer health status at baseline, but not at discharge.
Limitations to the study included a lack of data for diabetes characteristics including duration, severity, and control.
“[O]ur results support the notion that current guideline management is probably equally effective in [patients with acute MI] with and without diabetes,” the researchers said, “and thus increasing the use of healthcare services may lead to improved symptoms, function, and quality of life in patients with diabetes mellitus.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Ding Q, Funk M, Spatz ES, et al. Association of diabetes mellitus with health status outcomes in young women and men after acute myocardial infarction: results from the VIRGO study. J Am Heart Assoc. 2019;8:e010988.