Health utilities in Chinese patients with coronary heart disease and impaired glucose tolerance (ACE): A longitudinal analysis of a randomized, double-blind, placebo-controlled trial

Document Type

Article

Publication Date

7-1-2022

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

Cerebrovascular diseases, Economics, Prediabetic state, Quality of life, Vascular diseases

Divisions

medicinedept

Funders

Innovative Medicines Initiative 2 Joint Undertaking (Grant No: 115881),UK Research & Innovation (UKRI) Medical Research Council UK (MRC) (Grant No: MR/T018593/1),National Institutes of Health Research (NIHR),Bayer AG

Publication Title

Journal of Diabetes

Volume

14

Issue

7

Publisher

Wiley

Publisher Location

111 RIVER ST, HOBOKEN 07030-5774, NJ USA

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