中国冠心病合并糖耐量异常患者的健康相关生活质量:一项随机、双盲、安慰剂对照试验的纵向分析

Abstract

Abstract Background We estimate health‐related quality of life and the impact of four cardiovascular events (myocardial infarction [MI], stroke, congestive heart failure, angina) and gastrointestinal events in 6522 Chinese patients with coronary heart disease (CHD) and impaired glucose tolerance (IGT) participating in the Acarbose Cardiovascular Evaluation (ACE) trial. Methods Health‐related quality of life was captured using the EuroQol‐5 Dimension‐3 Level (EQ‐5D‐3L), with data collected at baseline and throughout the trial. Multilevel mixed‐effects linear regression with random effects estimated health‐related quality of life over time, capturing variation between hospital sites and individuals, and a fixed‐effects linear model estimated the impact of cardiovascular and gastrointestinal events. Results Patients were followed for a median of 5 years (interquartile range 3.4‐6.0). The average baseline EQ‐5D score of 0.930 (SD 0.104) remained relatively unchanged over the trial period with no evidence of statistically significant differences in EQ‐5D score between randomized treatment groups. The largest decrement in the year of an event was estimated for stroke (−0.107, P < .001), followed by heart failure (−0.039, P = .022), MI (−0.021, P = .047), angina (−0.012, P = .047), and gastrointestinal events (−0.005, P = .430). MI and stroke reduced health‐related quality of life beyond the year in which the event occurred (−0.031, P = .006, and −0.067, P < .001, respectively). Conclusions Acarbose treatment had no impact on health‐related quality of life in ACE trial participants with CHD and IGT. Events such as MI, stroke, heart failure, and angina reduce health‐related quality of life around the time they occurred, but only MI and stroke impacted on longer‐term health‐related quality of life.

Keywords

• 血管疾病
• 经济学
• 糖尿病前期状态
• 生活质量
• 脑血管疾病