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Obstructive coronary artery disease in high-risk diabetic patients with and without atrial fibrillation

Bredy Pierre-Louis1, Wilbert S Aronow, Chandrasekar Palaniswamy

  • 1Department of Medicine, Cardiology Division, New York Medical College, Valhalla, New York 10595, USA.

Coronary Artery Disease
|December 25, 2008
PubMed

Insights

Patients with diabetes and atrial fibrillation show more severe coronary artery disease than those with sinus rhythm. This includes a higher prevalence of significant narrowing in major coronary arteries.

Area of Science:

  • Cardiology
  • Diabetology
  • Electrophysiology

Background:

  • Diabetes mellitus and atrial fibrillation are independent risk factors for cardiovascular disease.
  • The combined effect of diabetes and atrial fibrillation on coronary artery disease (CAD) severity requires further investigation.

Purpose of the Study:

  • To compare the severity of coronary artery disease (CAD) in patients with diabetes mellitus and atrial fibrillation versus those with diabetes mellitus and sinus rhythm.

Main Methods:

  • A cohort of 245 patients with diabetes and atrial fibrillation was compared to 245 age- and sex-matched patients with diabetes and sinus rhythm.
  • All patients underwent coronary angiography to assess CAD severity.
  • Baseline characteristics and indications for angiography were similar between groups.

Main Results:

  • A higher prevalence of significant coronary artery narrowing (≥50%) was observed in patients with diabetes and atrial fibrillation (94%) compared to those with diabetes and sinus rhythm (86%) (P<0.01).
  • Specifically, severe three-vessel disease (≥50% narrowing) was more common in the diabetes and atrial fibrillation group (61%) than in the diabetes and sinus rhythm group (31%) (P<0.001).

Conclusions:

  • Patients with diabetes mellitus and concomitant atrial fibrillation exhibit a significantly greater prevalence and severity of coronary artery disease.
  • These findings highlight the increased cardiovascular risk associated with the co-occurrence of diabetes and atrial fibrillation.
Abstract

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