Cardiovascular risk factors, exercise capacity and health literacy in patients with chronic ischaemic heart disease and type 2 diabetes mellitus in Germany: Baseline characteristics of the Lifestyle Intervention in Chronic Ischaemic Heart Disease and Type 2 Diabetes study

Abstract

Background: Lifestyle interventions are a cornerstone in the treatment of chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). This study aimed at identifying differences in clinical characteristics between categories of the common lifestyle intervention targets BMI, exercise capacity (peak V̇O2) and health literacy (HL).

Methods: Cross-sectional baseline characteristics of patients enrolled in the LeIKD trial (Clinicaltrials.gov NCT03835923) are presented in total, grouped by BMI, %-predicted peak V̇O2 and HL (HLS-EU-Q16), and compared to other clinical trials with similar populations.

Results: Among 499 patients (68.3±7.7 years; 16.2% female; HbA1c, 6.9±0.9%), baseline characteristics were similar to other trials and revealed insufficient treatment of several risk factors (LDL-C 92±34 mg/dl; BMI, 30.1±4.8 kg/m2; 69.6% with peak V̇O2<90% predicted). Patients with lower peak V̇O2 showed significantly higher (p < 0.05) CIHD and T2DM disease severity (HbA1c, CIHD symptoms, coronary artery bypass graft). Obese patients had a significantly higher prevalence of hypertension and higher triglyceride levels, whereas in patients with low HL both quality of life components (physical, mental) were significantly reduced.

Conclusions: In patients with CIHD and T2DM, peak V̇O2, BMI and HL are important indicators of disease severity, risk factor burden and quality of life, which reinforces the relevance of lifestyle interventions.

Keywords: Lifestyle; cardiorespiratory fitness; chronic coronary syndrome; disease management; exercise capacity; secondary prevention.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: FE reported receiving grants from DFG, BMBF, Servier, and personal fees from Bayer Healthcare, Merck, Novartis, Servier, Berlin Chemie, Boehringer Ingelheim, Vifor Pharma, AstraZeneca and PharmaCosmos outside the submitted work. JB reported grants from AstraZeneca and personal fees from Amgen outside the submitted work. EBW reported receiving personal fees from Novartis (honoraria for lectures and advisory board activities), Boehringer Ingelheim (honoraria for advisory board activities) and CVRX (honoraria for lectures) outside the submitted work. BH reported receiving personal fees from IDS Diagnostic Systems outside the submitted work. MH reported receiving institutional funding from Techniker Krankenkasse (Health Insurance Company, Hamburg, Germany), grants from Novartis (principal investigator of the Activity Study in HFrEF) and personal fees from Bristol-Myers Squibb, Berlin Chemie-Menarini, Novartis, Daiichi-Sankyo, AstraZeneca, Roche, Abbott (advisory board on exercise and diabetes), Sanofi, Pfizer, Boehringer Ingelheim and Bayer, and serves as an advisor for Medical Park SE, Germany, outside the submitted work. All other authors (SMTD, JK, FG, JT, IFW, MG, KE, PvK, AD, OW, BW, FF, SN, TN, VA, SM) reported no conflict of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.

Patient recruitment in the LeIKD study. Abbreviations: CIHD, chronic ischaemic heart disease; T2DM, type 2 diabetes mellitus; aincluding re-screenings (initial screening failures may have been included during re-screening, n = 34).