A Comparative Angiographic Severity of Coronary Artery Disease in Diabetic and Non Diabetics in a Tertiary Cardiac Centre
2021
Introduction: Diabetes is a major risk factor for various cardiovascular
diseases including coronary artery disease. Coronary atherosclerosis is not
only more prevalent in diabetic patients but is also more severe. Diabetics
are more prone to multi vessel involvement as well as associated with poor
outcomes to acute coronary events.
Methods: This is a hospital based descriptive cross-sectional study including
300 patients (diabetic and non-diabetic) undergoing coronary angiography
at Sahid Gangalal National Heart Centre over a period of one year (January
to December 2016).
Results: Out of the total 300 patients studied at angiography, majority
(68.3%, 205 patients) were male with the age group ranging from 29 to
86 years of age. Significant number of diabetics had associated risk factor
as hypertension (88%) as the most common. Brahmins and Madhesi (27%
each) ethnic group of origin formed the major group studied. Significant
coronary artery disease defined as >50 % stenosis was evident in 118
patients (78.7%) among diabetics whereas it was present in 99 patients
(66%, p value 0.01, significant). Maximum number of diabetic patients had
presence of triple vessel disease ( 52 patients, 34.7 %) followed by double
vessel and single vessel disease ( 25.3 % and 18.7 %) respectively as well
as more number of diffuse vessel disease (28 % ,p value 0.006 ) . The mean
Gensini score studied was 33.07±28.7 with the highest Gensini score of
126. Diabetic group of patients had a higher Gensini scores (37.2 ± 28.4) as
compared to non-diabetic (28.9 ± 28.6, p value <0.05).
Conclusion: Diabetic patients had higher total Gensini scores at angiogram
which reflect greater severity of coronary artery disease as compared to
non-diabetics as well as higher incidence of triple vessel disease and diffuse
coronary artery disease.
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