Comparative Study of Coronary Angiographic Findings Between Diabetic and Non Diabetic Patients (original) (raw)
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Comparison of Extent of Coronary Artery Disease in Angiography of Diabetics and Non-Diabetics
… HEART JOURNAL (IHJ), 2006
Background-Type 2 diabetes mellitus is associated with an increased prevalence of atherosclerosis and coronary heart disease. This study was performed to determine the severity and extent of coronary artery disease in diabetics compared to non-diabetics. Methods-Fifty type 2 diabetic patients and 50 sex-and age-matched non-diabetics, who were candidates for angiography to diagnose coronary artery disease, were enrolled in the study. Those patients with valvular heart disease, congenital heart disease and rhythm disturbances were excluded from the study. Selective angiography was performed, and a single experienced observer reported the angiograms and Gensini scores were calculated to determine the severity of the atherosclerosis. Results-Sixty males and 40 females were included in the study, with a mean age of 57.3±8.4 (Mean ± SD). Diabetic patients had higher Gensini scores than non-diabetics (51.44 ± 44.6 vs. 34.12 ± 29.9, P<0.05). Categorical staging of various types of coronary artery disease significantly differed in diabetic and non-diabetics (P<0.05), and multi-vessel CAD (P<0.05) was seen more often in diabetics. Moreover, mono-vessel CAD (P<0.05) was more common in non-diabetics, but normal coronary arteries did not significantly differ between the two groups. Hyperlipidemia and diabetes were associated with Gensini scores independently (P=0.02 and P=0.04, respectively), and a trend toward a positive association was seen between family history of coronary artery disease and Gensini score (P=0.06), but hypertension and cigarette smoking did not show any significant association. Left main coronary artery disease, disease of the proximal portion of left anterior descending artery, presence of occluded vessels, ejection fraction, left ventricular end diastolic pressure, and catheter-based systolic and diastolic blood pressure were not significantly different between diabetics and non-diabetics. Conclusion-According to our study, diabetics may have more extensive coronary artery disease at presentation, hence care must be taken in the diagnosis and management of these patients, and it is better to maintain a lower threshold for performing noninvasive and sometimes invasive studies for the detection of coronary artery disease in diabetics (
Coronary Artery Disease Patterns in Diabetic Patients
Benha Medical Journal, 2022
Background: Cardiac involvement in diabetes usually manifest as coronary artery disease which is the main cause of mortality in diabetes. Definitive diagnosis, accurate assessment and anatomic severity of coronary artery disease requires invasive diagnostic tool like coronary angiography. Aim of study: We aimed to compare angiographic extents, type, number of vessels and SYNTAX score between acute coronary syndrome patients with and without diabetes. Patients and Methods: Prospective comparative study on 100 patients with acute coronary syndrome (50 patients with diabetes, and 50 patients without diabetes) were recruited to evaluate detailed angiographic coronary findings. Results and conclusion: A significant correlation was found between the degree of lesion complexity with both the number of vessels affected and the duration of diabetes mellitus. The higher the number of vessels affected and the longer the diabetes mellitus duration, the more complex is the lesion. Diabetes has a deleterious effect on the anatomy of coronary arteries, causing more multi-vessel and extensive coronary artery disease as well as higher SYNTAX score than in patients without diabetes.
Angiographic Severity and Extent of Coronary Artery Disease in Diabetic Patients
Endocrinologist, 2008
Studies of the characteristics of coronary artery disease (CAD) in diabetic patients have shown conflicting results. Only 2 studies exploring the severity of CAD, specifically in type 1 diabetes, have been published, and neither of them has used computer-aided quantitative coronary angiography. This retrospective study comprised 64 (24 women and 40 men) type 1 diabetic patients and nondiabetic control subjects. To estimate the severity, extent, and overall "atheroma burden" of CAD, we used quantitative coronary angiographic-based segmental analysis of coronary angiograms. Type 1 diabetic patients had greater global severity (p <0.001), global extent (p <0.001), and global atheroma burden (p <0.001) indexes than nondiabetic control subjects. Quantitative coronary angiographic-derived indexes of CAD were, on average, 1.4-to 4.3-fold higher in diabetic than in nondiabetic patients. These differences were particularly marked in women. We found that type 1 diabetic patients with a clinical indication for coronary angiography, especially women, have more severe, extensive, and distal type of CAD than individually matched nondiabetic control patients. Our findings, including a loss of sex difference for CAD among type 1 diabetic patients and a marked impact of type 1 diabetes in women, are not explained by established risk factors.
International Journal of Advances in Medicine, 2016
Background: Diabetes mellitus is one of the commonest disease worldwide ranking next to cardiovascular disorder. The estimated prevalence of diabetes among adults is expected to rise about 100% in future. Cardiac involvement in diabetes commonly manifests as CAD and less commonly as dilated (diabetic) cardiomyopathy and autonomic cardiovascular neuropathy. The risk of CAD among diabetic patients is directly related to the levels of blood pressure, cigarette smoking and total cholesterol. Methods: The present study was undertaken at Chandulal Chandrakar memorial hospital, Bhilai, Chhattisgarh (India) between the periods of September 2010-2012 (2 years). 120 cases of CAD were studied, out of which 60 cases are diabetic CAD and 60 cases are non-diabetic CAD. Sample is drawn by simple random technique. Ethical approval was obtained from institutional ethical committee. Total Cases-120, Diabetic CAD [group-1]-60 and Non-diabetic CAD [group-2]-60. On recruiting the subjects into Group 1 and Group 2 following protocol is followed-history, clinical examination, pt. stabilization, anthropometric measurement, routine investigations, specific investigations including echocardiography. Procedures, definitions and criteria were used in the study as per standard protocol. In the present study values are expressed as mean ±1 SD. Demographic characteristics of patient with or without diabetes and other unpaired variables were compared. Results: Mean age in diabetic group was (55.7 ± 9.5) years while in non-diabetic group (55.6 ± 9.32) years. Diabetic group consists of 42 males and 18 females. Non Diabetic Group consists of 38 males and 22 females. Most of the patients in diabetic group presented with chest pain with sweating and with symptoms of sympathetic stimulation (vomiting/ apprehension 83.33%). A small fraction of diabetic patients presented with breathlessness-20%, syncope (3.33%) and palpitation (8.3%). In diabetic group 55% of patients were hypertensive, pre-HTN was seen in 18.33% and 26.66% had optimal blood pressure. Non-diabetics have higher ideal body weight 58.33% than diabetic (36.66%). Among the diabetic group and non-diabetic group maximum number of cases belonged to low risk category with total cholesterol, triglycerides and LDL cholesterol, but with borderline risk with HDL cholesterol. Diabetics are more vulnerable to mortality than non-diabetics (p<0.05). Conclusions: Diabetics had considerably higher percent of typical and atypical presentation. Hence, CAD should be considered as one of the differential diagnoses in diabetics who have presented with chest pain, however less severe it may be.
University Heart Journal, 2015
Coronary artery disease (CAD) is an important medical and public health problem with an approximately 7.2 million deaths/year, or 12% of all deaths worldwide annually and the single most important cause of death in developed countries. Rapid urbanization, life style change and economic growth in developing countries have led to a substantial increase in coronary heart disease (CHD). 1 Like other developing countries, the prevalence of ischemic heart disease (IHD) is increasing in Bangladesh and emerged as an important cause of mortality and morbidity with reported incidence of 3.3/1000 populations and 100/ 1000 adult populations in 1975 and 2002, respectively. 2,3 Diabetes mellitus (DM) is an important risk factor for coronary heart disease. Cardiac involvement in diabetes commonly manifest as coronary artery disease (CAD) and less commonly as diabetic cardiomyopathy and cardiac autonomic neuropathy. Compared with non diabetic individuals, diabetic patients have a twofold to fourfold increased risk for development and dying of CHD. Diabetes is associated with an increased risk for MI and has worse cerebrovascular (CVD) outcomes after ACS events. Rising frequency of CAD in diabetic patients has been widely documented in hospital, autopsy, and epidemiological as well as longitudinal studies in several populations. Association of more extensive CAD with DM has been described in post-mortem, angiographic and IVUS-based studies and in studies with multi-slice coronary computed angiography. 4 Coronary angiography (CAG), the gold standard for the diagnosis and characterization of CHD, offers therapeutic options and determines prognosis. Heterogeneity of the composition, distribution, and location of atherosclerotic plaque within the coronary arteries also help predict procedural outcome and complications after PCI. 5 Criteria established by a joint American College of Cardiology/ American Heart Association (ACC/AHA) task force suggested that procedure success and complication rates are related to a number of different lesion characteristics. 6
A comparative study of coronary artery disease in diabetics and non-diabetics
International Journal of Research in Medical Sciences, 2016
Cardiovascular diseases accounts for the greatest burden of morbidity and mortality worldwide, both in developed and in developing countries. Key cardiovascular risk factors, including hypertension, cigarette smoking, high blood glucose, physical inactivity, obesity, and elevated cholesterol are the top leading causes of death worldwide. 1 Coronary heart disease makes up more than half of all CVD deaths in men and women under 75 years of age, is eases with a lifetime risk of developing CHD after age 40 years, of 49 per cent for men and 32 per cent for women (Go AS et al.). 2 The worldwide prevalence of diabetes has mellitus has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 177 million in 2000. 3 In the US, the centre for disease control and prevention (CDC) estimated that 20.8 million persons or around 7% of population is having diabetes in 2005 and ABSTRACT Background: Cardiovascular diseases accounts for the greatest burden of morbidity and mortality worldwide, both in developed and in developing countries. Coronary Heart Disease makes up more than half of all CVD deaths in men and women under 75 years of age, is eases with a lifetime risk of developing CHD after age 40 years, of 49 per cent for men and 32 per cent for women. The Framingham study showed that the risk of cardiovascular death was increased 4-5 fold in women and 2 fold in men with predominantly type-2 diabetes mellitus. Methods: The present study was undertaken at
The American Journal of Cardiology, 2000
Studies of the characteristics of coronary artery disease (CAD) in diabetic patients have shown conflicting results. Only 2 studies exploring the severity of CAD, specifically in type 1 diabetes, have been published, and neither of them has used computer-aided quantitative coronary angiography. This retrospective study comprised 64 (24 women and 40 men) type 1 diabetic patients and nondiabetic control subjects. To estimate the severity, extent, and overall "atheroma burden" of CAD, we used quantitative coronary angiographic-based segmental analysis of coronary angiograms. Type 1 diabetic patients had greater global severity (p <0.001), global extent (p <0.001), and global atheroma burden (p <0.001) indexes than nondiabetic control subjects. Quantitative coronary angiographic-derived indexes of CAD were, on average, 1.4-to 4.3-fold higher in diabetic than in nondiabetic patients. These differences were particularly marked in women. We found that type 1 diabetic patients with a clinical indication for coronary angiography, especially women, have more severe, extensive, and distal type of CAD than individually matched nondiabetic control patients. Our findings, including a loss of sex difference for CAD among type 1 diabetic patients and a marked impact of type 1 diabetes in women, are not explained by established risk factors.
Journal of The American College of Cardiology, 2001
The goal of this research was to study coronary atherosclerosis in patients with type 2 diabetes compared with patients without diabetes according to the new definition of diabetes advocated by the American Diabetes Association in 1997. BACKGROUND Patients with diabetes (fasting plasma glucose above 7.0 mM/L) have a higher risk of cardiovascular death. The correlation with the pattern and severity of their coronary atherosclerosis, especially in the new patients with "mild" diabetes (7.0 mM/L Յ fasting plasma glucose Ͻ 7.8 mM/L), remains unclear.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022
Introduction: Patients with type-2 diabetes are at high risk for many Cardiovascular Diseases (CVD) such as coronary artery disease, stroke, peripheral arterial disease, cardiomyopathy, and congestive heart failure. Aim: To evaluate the coronary angiography profile in diabetics and non diabetics presenting with Acute Coronary Syndrome (ACS) in a tertiary care hospital in eastern India. Materials and Methods: This case-control study comprised 200 patients (100 were diabetics and 100 were non diabetics) diagnosed with ACS based on Electrocardiography (ECG) and cardiac enzymes. Data about baseline demographic, clinical and angiographic characteristics were collected. Moreover, angiographic thrombus burden grade, Cohen and Rentrop grade for collateral circulation, and Synergy Between Percutaneous Coronary intervention with Taxus and Cardiac Surgery(SYNTAX) score were also reported. Results: The mean number of vessel involvement was significantly higher in diabetics as opposed to non dia...