Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

Abstract

We examined the impact of co-occurring diabetes and hopelessness on 3-year prognosis in percutaneous coronary intervention patients. Consecutive patients (n = 534) treated with the paclitaxel-eluting stent completed a set of questionnaires at baseline and were followed up for 3-year adverse clinical events. The incidence of 3-year death/non-fatal myocardial infarction was 3.5% in patients with no risk factors (neither hopelessness nor diabetes), 8.2% in patients with diabetes, 11.2% in patients with high hopelessness, and 15.9% in patients with both factors (p = 0.001). Patients with hopelessness (HR: 3.28; 95% CI: 1.49-7.23) and co-occurring diabetes and hopelessness (HR: 4.89; 95% CI: 1.86-12.85) were at increased risk of 3-year adverse clinical events compared to patients with no risk factors, whereas patients with diabetes were at a clinically relevant but not statistically significant risk (HR: 2.40; 95% CI: 0.82-7.01). These results remained, adjusting for baseline characteristics and depressive symptoms. These findings testify to the importance of identifying patients with co-occurring risk factors, as they likely require special management in clinical practice in addition to standard medical treatment.

Extending Clinical Practice to Medicine

“…A needs assessment of the teaching of health care instruction and monitoring of blood glucose level addressed the parent concern, child's medical need and safeguarded child's medical progress. Thus, the controllable chronic disease of diabetes can be treated by the Medical Psychologist with, in this instance, Psychoeducation and parent training about their child's diabetes disease [25].…”