Objective: To assess the health-related quality of life (HRQoL) in diabetic patients who have followed a protocol of intensive treatment of cardiovascular risks (CVR).
Design: Clinical trial randomised by cluster. A convenience sample of 65 primary care practitioners, randomly assigned to a control or intervention group. Patients were selected by systematic sampling from diabetic lists. The follow-up for the control group was by normal practice and the intervention group by using the intensive control of cardiovascular risk factors (CVRF) protocol.
Setting: Seventeen health-centres in the Valencia Community, Spain.
Participants: One hundred and eighty-four patients, 93 in the control group and 91 in the intervention group.
Inclusion Criteria: patients diagnosed with diabetes mellitus (DM) type 2, aged between 45-75 years, DM for more than 2 years and less than 20 years and a cardiovascular risk (CVR) >20% after 10 years (Framingham equation). The exclusion criteria were: history of ischaemic heart disease, terminal illness, hepatic cirrhosis, renal failure, grade III-IV cardiac failure, and mental disorders. The patients self-completed the Spanish versions of the COOP/WONCA charts and a diabetes-specific tool (ADDQol questionnaire) at the start, and after 6 months and 12 months.
Main Measurements: Means of COOP/WONCA charts and ADDQol. Comparison between groups using Mann-Whitney U test, and the group follow ups using the Wilcoxon test.
Results: No significant differences were found in the COOP/WONCA charts. At 12 months the only significant difference was in the feelings chart (P=.024; control group 1.86+/-1.03: intervention group 2.23+/-1.11). A negative impact of diabetes was seen in all the dimensions of ADDQoL. The most negative impact of diabetes was related to diet. There were no significant differences between groups in the ADDQoL throughout the study.
Conclusions: The HRQoL in diabetic patients is not affected by intensive therapy of cardiovascular risk factors. Diabetes has a negative impact on HRQoL in the patients studied.
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http://dx.doi.org/10.1157/13101795 | DOI Listing |
Circ Genom Precis Med
January 2025
Mary and Steve Wen Cardiovascular Division, Department of Medicine, University of California, Los Angeles. (W.F., N.D.W.).
Background: Lp(a; Lipoprotein[a]) is a predictor of atherosclerotic cardiovascular disease (ASCVD); however, there are few algorithms incorporating Lp(a), especially from real-world settings. We developed an electronic health record (EHR)-based risk prediction algorithm including Lp(a).
Methods: Utilizing a large EHR database, we categorized Lp(a) cut points at 25, 50, and 75 mg/dL and constructed 10-year ASCVD risk prediction models incorporating Lp(a), with external validation in a pooled cohort of 4 US prospective studies.
Circ Arrhythm Electrophysiol
January 2025
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (T.H., M.E.R., O.Y., G.N.K., N.O., T.K., L.N., D.L.P., K.C.S.).
Background: Power-controlled radiofrequency ablation with irrigated-tip catheters has been the norm for ventricular ablation for almost 2 decades. New catheter technology has recently integrated more accurate tissue temperature sensing enabling temperature-controlled irrigated ablation. We aimed to investigate the in vivo ablation parameters and lesion formation characteristics in ventricular myocardium using a novel temperature-controlled radiofrequency catheter.
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January 2025
Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston. (S.M.U., K.P., B.T., A.C.F., P.N.).
Background: Earlier identification of high coronary artery disease (CAD) risk individuals may enable more effective prevention strategies. However, existing 10-year risk frameworks are ineffective at earlier identification. We sought to understand how the variable importance of genomic and clinical factors across life stages may significantly improve lifelong CAD event prediction.
View Article and Find Full Text PDFCirc Genom Precis Med
January 2025
Centre for Heart Lung Innovation, University of British Columbia, Vancouver. (K.H., M.A., L.R., Y.L., A.S., H.H., L.R.B., Z.W.L.).
Background: Protein-truncating mutations in the titin gene are associated with increased risk of atrial fibrillation. However, little is known about the underlying pathophysiology.
Methods: We identified a heterozygous titin truncating variant (TTNtv) in a patient with unexplained early onset atrial fibrillation and normal ventricular function.
Circ Genom Precis Med
January 2025
Garvan Institute of Medical Research, University of New South Wales, Sydney, Australia. (A.B., J.S., A.C., J.I.).
Background: Females with hypertrophic cardiomyopathy present at a more advanced stage of the disease and have a higher risk of heart failure and death. The factors behind these differences are unclear. We aimed to investigate sex-related differences in clinical and genetic factors affecting adverse outcomes in the Sarcomeric Human Cardiomyopathy Registry.
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