Clinical research studyMultiple Chronic Conditions and Psychosocial Limitations in Patients Hospitalized with an Acute Coronary Syndrome
Section snippets
Methods and Materials
Details of the study design, patient recruitment, and data collection activities for this longitudinal study have been described previously.14 In brief, TRACE-CORE used a multisite prospective cohort design to recruit and follow a cohort of 2174 eligible and consenting adults hospitalized with an acute coronary syndrome at 3 medical centers in Worcester, Mass, 1 in Macon, Ga, and 2 in Atlanta, Ga.14
Participating study sites served a heterogeneous patient population and were selected purposely
Results
The average age of our study population (n = 2174) was 61.3 years; 67% were men, 81% were white, and 25% had completed college.
Discussion
In this multisite observational study, approximately 2 of every 5 patients discharged alive after a hospitalization for an acute coronary syndrome had 4 or more previously diagnosed morbidities. Patients presenting with multiple chronic conditions were more likely to report stress, depression, and anxiety; these multimorbid patients had a lower quality of life, low health literacy and numeracy, and were more likely to be cognitively impaired than patients with no or just one morbidity.
In terms
Conclusions
In this study of nearly 2200 patients discharged from the hospital after an acute coronary syndrome in 6 medical centers in central Massachusetts and Georgia, we observed a high prevalence of multiple cardiac-related and noncardiac chronic conditions. Multimorbidity was associated strongly with measures of psychosocial impairment and worse quality of life. Given the aging US population, the multimorbidity burden in patients with an acute coronary syndrome will likely continue to increase during
Acknowledgment
We are indebted to the trained study staff at each of our participating study sites in Worcester, MA, Macon, GA, and Atlanta, GA.
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2022, International Journal of CardiologyCitation Excerpt :Previous studies have focused on individual comorbidities or multimorbidity phenotype clusters among CHD or MI survivors in Western countries [4,5,19–21]. Our current study discussed the multimorbidity of patients with coronary heart disease (including ACS and chronic coronary artery disease) and found that the prevalence of diabetes, hypertension and dyslipidemia was high in multimorbidity patients, which was consistent with the results of previous studies [4,22]. The consistency could be due to these diseases being concordant conditions, and they have a mutual influence or common etiology in terms of pathogenesis or treatments.
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Funding: The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education study was supported by National Institutes of Health (NIH) grant U01HL105268. MT is funded by the National Heart, Lung, and Blood Institute Diversity Supplement R01 HL35434-29 and by the 1R24AG045050 from the National Institute on Aging, Advancing Geriatrics Infrastructure & Network Growth (AGING). DDM is supported by NIH award 1R15HL121761 and KL2RR031981. JSS is supported by award number K01AG033643 from the National Institute of Aging. JG is supported by award number 1R24AG045050 from the National Institute on Aging, Advancing Geriatrics Infrastructure & Network Growth (AGING). MEW is supported by NIH grant KL2TR000160.
Conflict of Interest: There are no conflicts of interest with any of the authors to report.
Authorship: All authors had access to the data and had a role in writing this manuscript.