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Diabetes Res Clin Pract. 2017 Aug;130:24-33. doi: 10.1016/j.diabres.2016.12.019. Epub 2017 Jan 23.

Health-related quality-of-life implications of cardiovascular events in individuals with type 2 diabetes mellitus: A subanalysis from the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR)-TIMI 53 trial.

Author information

1
Health Economics & Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, United Kingdom. Electronic address: andrew.briggs@glasgow.ac.uk.
2
TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
3
Diabetes Unit, Hadassah Hebrew University Hospital, PO Box 12000, Jerusalem 91120, Israel.
4
Broad Street Health Economics & Outcomes Research, 4016 Glen Dr, Vancouver V5V 4T3, Canada.
5
AstraZeneca, 431 83 Molndal, Sweden.
6
Bristol-Myers Squibb, 5 Research Parkway, Wallingford, CT 06492, USA.
7
MedImmune, One Medimmune Way, Gaithersburg, MD, 20878, USA.

Abstract

BACKGROUND:

The impact of cardiovascular complications on health-related quality-of-life (HRQoL) in type 2 diabetes mellitus has not been clearly established. Using EQ5D utility data from SAVOR-TIMI 53, a large phase IV trial of saxagliptin versus placebo, we quantified the impact of cardiovascular and other major events on HRQoL.

METHODS:

EQ5D utilities were recorded annually and following myocardial infarction (MI) or stroke. Utilities among patients experiencing major cardiovascular events were analyzed using linear mixed-effects regression, adjusting for baseline characteristics (including EQ5D utility), and compared to those not experiencing major cardiovascular events. Mean utility decrements with standard errors (SE) were estimated as the difference in utility before and after the event.

FINDINGS:

The mean EQ5D utility of the sample was 0.776 at all time points, and did not differ by treatment. However, mean baseline and month 12 utilities among those with a major cardiovascular event were 0.751 and 0.714. Mean utilities were 0.691 within 3months of, 0.691 3-6months after, and 0.714 6-12months after, a major cardiovascular event. Cardiovascular event-specific utility decrements were 0.05 (0.007) for major cardiovascular events over the same time periods. Decrements of 0.051 (0.012; myocardial infarction), 0.111 (0.022; stroke), 0.065 (0.014; hospitalization for heart failure) 0.019 (0.024; hospitalization for hypoglycemia) were estimated; all coefficients were statistically significant.

INTERPRETATION:

Consistent with clinical outcomes reported elsewhere, saxagliptin did not improve HRQoL. Cardiovascular complications were associated with significantly decreased HRQoL, most substantial earlier after the event.

FUNDING:

BMS/AZ.

KEYWORDS:

Cardiovascular; Diabetes mellitus; Health-related quality of life

PMID:
28554140
DOI:
10.1016/j.diabres.2016.12.019
[Indexed for MEDLINE]
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