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Coronary angiographic findings in patients with diabetes: an exercise in cardiovascular epidemiology
S Krishnaswami1, G Joseph, E Punnoose
1Dept of Cardiology, Christian Medical College Hospital, Vellore, Tamilnadu.
Insights
Diabetic patients with chest pain show a high prevalence of coronary artery disease (CAD), with disease severity increasing with age. Diabetes significantly worsens coronary artery disease in Indian patients compared to non-diabetics.
Area of Science:
- Cardiology
- Diabetology
- Medical research
Background:
- Coronary artery disease (CAD) is a significant health concern.
- Diabetes mellitus is a known risk factor for cardiovascular complications.
- The impact of diabetes on CAD prevalence and severity in Indian populations requires detailed investigation.
Purpose of the Study:
- To determine the prevalence and severity of CAD in diabetic patients presenting with chest pain.
- To compare CAD characteristics between diabetic and non-diabetic individuals.
- To explore the relationship between diabetes, age, and CAD progression.
Main Methods:
- A case-control study involving 516 diabetic patients with chest pain and 516 matched non-diabetic controls.
- Selective coronary arteriography was performed for all participants.
- Angiographic analysis included prevalence, multivessel involvement, Gensini score, and occluded segments.
Main Results:
- Prevalence of CAD in symptomatic diabetics was 86.6%, increasing with age.
- Diabetics exhibited higher rates of multivessel disease (p < 0.01) and proximal-distal segment involvement (p < 0.01).
- The Gensini score and number of occluded segments were significantly higher in diabetics (p < 0.05 and p < 0.01, respectively).
Conclusions:
- Diabetes adversely affects coronary arteries in Indian patients, leading to a higher prevalence and severity of CAD.
- CAD prevalence in diabetics escalates linearly with age.
- No correlation was found between disease severity and age, BMI, or diabetes duration.
Abstract:
A study of 516 patients with diabetes mellitus who presented with chest pain and an equal number of matched controls without diabetes examined by selective coronary arteriography was undertaken. Detailed analysis of the angiograms showed that prevalence of CAD in diabetics with symptoms was 86.6%. This prevalence increased with age. Multivessel disease was more common in diabetics that in controls (p < 0.01). In diabetic patients disease involvement of proximal and distal segments in the same vessel was more common (p < 0.01). The Gensini score of quantitative expression of severity of CAD was higher in diabetics (p < 0.05). The number of occluded segments in the coronary tree was higher in diabetics (p < 0.01). No correlation could be established between severity of disease and age, body mass index or duration of diabetes. It is concluded that diabetes affects the coronary arteries of Indian patients more adversely than those of non-diabetics. The prevalence of CAD among diabetics increases linearly with age.