Data Suggest Diabetics Have Worsening Symptoms Prior to Acute Cardiac Event

November 2003 - New data presented by Emory researchers at the American Heart Association's Scientific Sessions abstract poster sessions address angina related quality of life in diabetic and non-diabetic patients undergoing percutaneous coronary intervention (PCI), medical procedures performed in catheterization laboratories to reduce the amount of narrowing in a coronary artery due to plaque formation.

According to Emory Heart Center cardiologist William Weintraub, M.D. FACC, who headed the research team, people with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors. They are also more likely to undergo PCI. "However, the impact of cardiac symptoms on quality of life in diabetics with PCI has not been systematically analyzed before," says Dr. Weintraub, who is Director of the Emory Center for Outcomes Research.

The Emory University Division of Cardiology, School of Medicine and School of Nursing researchers studied patients undergoing PCI on a non-emergency basis at Emory University Hospital in Atlanta over a five month period. The research subjects completed the Seattle Angina Questionnaire (SAQ), which measures angina-related quality of life, and scores were compared to those of non-diabetics. Other variables, including gender, age, race, prior revascularization, smoking status, hypertension, renal function, lipid levels, medications, and anatomy were collected.

Tests were also conducted to see which patients met the criteria for a non-Q-wave myocardial infarction (NQWMI). A NQWMI is a heart attack caused by a ruptured plaque in a coronary artery and a resulting blood clot that is usually non-occlusive, typically causing less damage to the heart muscle . Levels of troponin, an enzyme found only in heart muscle tissue that can reveal heart attacks that might not show up definitively on other tests such as an EKG, were measured to determine whether or not an NQWMI had occurred.

"We found that diabetics presenting for elective angioplasty do not differ significantly from non-diabetics in their angina-specific quality of life. However, in those who have experienced a NQWMI, diabetes predicts greater physical limitation even though although angina stability and frequency did not differ," says Dr. Weintraub. "This is an important finding because it could indicate that diabetics have had worsening symptoms and disability prior to the acute event."

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Source: Emory University