Association between Diabetic Retinopathy and Left Ventricular Dysfunction in Diabetic Patients with Unstable Angina

Diabetes mellitus (DM) is associated with serious complications including macro- and microvascular problems such as diabetic retinopathy. Coronary involvement in diabetic patients is believed to be a consequence of microvascular complications. However, the available data are inconclusive and scarce. This study aimed to evaluate the probable association between diabetic retinopathy and left ventricular dysfunction in diabetic patients with unstable angina (UA).

In this cross-sectional study, 200 diabetic patients with UA (100 cases with diabetic retinopathy and 100 cases without diabetic retinopathy) were enrolled in a teaching hospital. Left ventricular ejection fraction (LVEF) as well as the frequency of cases with left ventricular dysfunction (LVEF<50%) were compared between the two groups and different degrees of diabetic retinopathy (proliferative and non-proliferative).

Patients' demographic variables were comparable between the two groups. Mean diagnosis time of DM was significantly higher in the patients with diabetic retinopathy (8.40±6.60 vs. 3.81±3.58 years; P<0.001). Mean LVEF was significantly lower in the retinopathy group (50.50±6.91% vs. 53.07±4.87%; P=0.003). Frequency of cases with left ventricular dysfunction was significantly higher in the group with diabetic retinopathy (31% vs. 12%; P=0.001, OR=3.33, 95%CI: 1.58-7.14). The frequency of cases with left ventricular dysfunction was significantly yet independently higher in patients with proliferative vs. non-proliferative diabetic retinopathy.

Left ventricular dysfunction is more common in diabetic patients with unstable angina and diabetic retinopathy compared with their counterparts without diabetic retinopathy.