Title : Features of clinical and biochemical parameters, quality of life and prognosis of patients with CAD in combination with type 2 diabetes and COPD
Abstract:
Aim: Assessment of the clinical condition, quality and prognosis of life in a cohort of CAD patients in comorbidity with other chronic-non-communicable diseases (COPD and type 2 diabetes).
Materials and methods: A cohort study included 220 patients of both sexes aged 39 to 69 years old. In order to study the association of CAD with other NCD, the patients were divided into 3 groups: patients with CAD without comorbidity (group I, n = 80), with CAD and type 2 diabetes (group II, n = 70) and CAD with COPD (group III, n = 70). All patients underwent: history taking, ECG registration at rest, echoCG, and biochemical blood tests. Quality of life was assessed using the international questionnaire EQ-5D and the analog scale EQVas. To determine the prognosis of 10-year survival, the Charlson comorbidity index was used.
Results: The average SBP was the highest among patients with CHD and type 2 diabetes. According to EchoCG in the groups of patients with CAD with comorbidity, the average values of the interventricular septum thickness and left ventricular myocardial mass index were statistically significantly higher compared with the group of patients without comorbidity (117.03 ± 19.59 g (group II) vs 108.73 ± 27.44 g ( Group III) vs 99.15 ± 13.48 g (group I) - p <0.01). The level of triglycerides was highest in the group of CHD and type 2 diabetes, while other lipid metabolism indicators were comparable in all three groups. Evaluation of psychometric and physical parameters of quality of life showed that the severity of discomfort and decrease in mobility were significantly higher in groups with COPD and type 2 diabetes. According to the EQVas visual analogue scale, in the groups of patients with CAD and comorbidity, self-assessment of health was lower (p <0.01). An analysis of the 10-year survival prognosis for the Charlson comorbidity index showed that in both groups with comorbidity, this indicator was high compared with the control group, but in patients with CAD in combination with type 2 diabetes, its severity was 20% higher than in the group with COPD.
Conclusion: Thus, comorbidity of CAD with type 2 diabetes and COPD is associated with deterioration in the quality of life and a predicted survival rate for the comorbidity index. Patients with CAD and type 2 diabetes showed the worst indicators of prognosis, quality of life and clinical and biochemical parameters
