Comparison of Quality-of-Life Outcomes After Percutaneous Coronary Intervention in Diabetic and Non-diabetic Patients
Mohmmad D Selim1, Jahanara Arzu2, Md Fakhrul Hasan3
1Department of Cardiology, Bangladesh Specialized Hospital, Dhaka, BGD.
Abstract:
Introduction Diabetes mellitus is a well-established risk factor for adverse cardiovascular outcomes, including non-ST-elevation myocardial infarction (NSTEMI). Percutaneous coronary intervention (PCI) is a standard treatment, but the comparative impact on health-related quality of life (HRQoL) between diabetic and nondiabetic NSTEMI patients remains underexplored. This study aimed to compare HRQoL after PCI between these two groups. Methods A prospective observational study was conducted at the Department of Cardiology, Bangladesh Medical University, Dhaka, Bangladesh, from August 1, 2023, to July 31, 2024. A total of 90 NSTEMI patients who underwent PCI (45 diabetic patients and 45 nondiabetic patients) were recruited. Sociodemographic, clinical, and laboratory data were collected via a semi-structured questionnaire. HRQoL was assessed at baseline and six months post-PCI using the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Data were analyzed using Chi-square tests, Mann-Whitney U tests, t tests, and Wilcoxon signed-rank tests (p < 0.05 was considered significant). Results Diabetic patients had significantly higher rates of obesity (8, 17.8%) compared with non-diabetic patients (p = 0.006), and dyslipidemia (21, 46.7% vs. 9, 20.0%, p = 0.007). Both groups demonstrated significant improvements in HRQoL across all domains after PCI. Non-diabetic patients had higher physical domain scores at baseline (42.05 ± 10.53 vs. 30.06 ± 15.15, p = 0.001) and at six months (76.94 ± 9.40 vs. 69.30 ± 16.54, p = 0.033). Diabetic patients reported significantly higher environmental domain scores at baseline (79.68 ± 7.54 vs. 76.05 ± 7.40, p = 0.003) and at follow-up (89.98 ± 5.19 vs. 87.06 ± 7.16, p = 0.032). Psychological and social domain scores improved similarly in both groups, with no significant post-PCI differences. Symptom relief was greater among non-diabetic patients, with 42 (93.3%) achieving Class I angina, compared with 33 (73.3%) diabetic patients (p = 0.029), and dyspnea outcomes were superior, with 44 (97.8%) versus 36 (80.0%) patients in New York Heart Association (NYHA) Class I, respectively (p = 0.007). Conclusion PCIs significantly enhance HRQoL in NSTEMI patients, regardless of diabetes status. However, diabetic patients experience slower recovery in the physical domain and more persistent symptoms, suggesting the need for targeted post-PCI management to optimize functional outcomes.
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