This collaborative project involves analysis of health-related quality of life (HRQL) data collected in the APPROACH databases. The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) is a clinical data collection and outcome monitoring initiative capturing all patients undergoing cardiac catheterization and revascularization in the province of Alberta, Canada, since 1995.

The aim of this project is to determine the relative HRQL deficits for cardiac patients who have diabetes as a comorbidity compared to cardiac patients without diabetes. Among all patients captured in the APPROACH database, we will compare the self-reported health status at one-year following revascularization. Self-reported HRQL is collected using two instruments, the EuroQoL EQ-5D, and the Seattle Angina Questionnaire (SAQ). Scores on these two instruments for patients with diabetes will be compared to those without diabetes, as well as other important comorbidities, including cerebrovascular disease, peripheral vascular disease and renal disease. All comparisons will control for age, sex, and clinical information, such as ejection fraction, the affected coronary anatomy and indication for catheterization. We anticipate observing lower HRQL outcomes in people with diabetes, but the magnitude of this difference is not known.

Research Team

William Ghali, Jeff Johnson, Sumit Majumdar, Colleen Norris


ACHORD NET (Canadian Institutes of Health Research, Canadian Diabetes Association, Heart and Stroke Foundation, Kidney Foundation)


Hubacek J, Galbraith PD, Gao M, Humphries K, Graham MM, Knudtson ML, Ghali WA; APPROACH investigators. External validation of a percutaneous coronary intervention mortality prediction model in patients with acute coronary syndromes. Am Heart J 2006 Feb;151(2):308-15.

Southern DA, Knudtson ML, Ghali WA; APPROACH Investigators. Myocardial infarction on snow days: incidence, procedure, use and outcomes. Can J Cardiol 2006 Jan;22(1):59-61.