Author + information
- Suzanne Arnold,
- John Spertus,
- Kasia Lipska,
- Fengming Tang,
- Abhinav Goyal,
- Darren McGuire,
- Sharon Cresci,
- Thomas Maddox and
- Mikhail Kosiborod
Patients with DM have more extensive coronary disease and worse survival after MI compared with patients without DM. However, the association of DM with angina after MI is unclear.
We examined the presence of angina, using the Seattle Angina Questionnaire (4 week recall), at admission and 1, 6, and 12M after MI among 3612 MI patients (30% with prevalent DM) from 24 US hospitals. A hierarchical, multivariable, repeated measures model examined the independent association of DM with post-MI angina over the 12M of follow-up. Interactions of DM with other patient and treatment variables were examined.
Patients with DM had higher unadjusted prevalence of angina pre-MI than patients without DM (49% vs 42%, p<0.001) and at each follow-up point (e.g. 12M: 28% vs 21%, p<0.001). In a multivariable model (Figure), DM was associated with a greater odds of angina over the 12M follow-up, an association that increased in magnitude over time (DM*time interaction p=0.012). In addition, DM was associated with increased odds for angina in patients without multivessel disease but not among those with multivessel disease (interaction p=0.075).
Contrary to conventional wisdom, angina is more prevalent among patients with DM than those without DM, both prior to and following AMI. This effect is amplified over time and is more pronounced among patients without multivessel disease, which may be due to more diffuse nature of coronary disease among DM patients.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Surprises and Controversies in Outcomes Research
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1243M-93
- 2013 American College of Cardiology Foundation