Diabetes, but not the metabolic syndrome, predicts the severity and extent of coronary artery disease in women.

Background: Previous studies have suggested that diabetes and metabolic syndrome are significant risk factors for coronary artery disease (CAD). However, in women, their relative importance remains controversial. Aim: To evaluate risk factors for CAD in women and their association with the severity and extent of coronary angiographic findings. Methods: We clinically evaluated 243 consecutive female patients with chest pain who underwent coronary angiography. The location and extent of coronary artery occlusions were assessed using the modified Gensini index. Results: Compared with women with normal coronary arteries ( n = 90), those with CAD ( n = 153) reported less physical activity ( p = 0.001), and had higher prevalences of diabetes ( p = 0.046), hypertension ( p = 0.002), and the metabolic syndrome ( p = 0.001). They also had lower HDL cholesterol levels ( p = 0.017), higher levels of triglycerides ( p = 0.005), and higher fasting plasma glucose (FPG) ( p < 0.001). Physical activity, FPG, serum triglycerides and HDL-cholesterol, but not the metabolic syndrome, were independent predictors of CAD. A score combining the extent and severity of angiographic findings was significantly higher in women with diabetes ( p = 0.007), hypertension ( p = 0.010) and FPG ⩾100 mg/dl ( p = 0.031), but showed no association with the metabolic syndrome. In a multivariate linear regression analysis, diabetes was an independent predictor of the extent and severity of angiographic score ( p = 0.013). Discussion: Diabetes, fasting plasma glucose and hypertension, but not the metabolic syndrome, were associated with severity of coronary angiographic findings in these women.