Arch Hellen Med, 28(2), March-April 2011, 245-250
The association of diabetes mellitus with the severity of angiographic findings
V. Peppes, A. Panoutsopoulos, G. Rammos, N. Zakopoulos
OBJECTIVE The purpose of this study was to compare the severity of angiographic findings in patients with newlydiagnosed coronary artery disease (CAD) with and without diabetes mellitus (DM).
METHOD A retrospective study was performed on 115 inpatients with new-onset CAD presenting with either acute myocardial infarction (n=84) or unstable angina (n=31) between 2005 and 2007, who underwent coronary angiography during hospitalization. A history of previous cardiovascular disease (stroke, peripheral arterial disease, atrial fibrillation) was sought in the study participants and medical treatment prior to hospitalization was recorded. Measurement of serum myocardial enzymes and lipids was performed in all patients. The Gensini score was calculated to assess CAD severity, taking into account the number and degree of vascular stenotic lesions and their anatomical location. Statistical analysis was performed using Chi-square and Student's T-test.
RESULTS The incidence of DM in the study population was 20.9% (n=24). For the patients with DM, antidiabetic treatment before hospital admission included monotherapy or combination therapy in 20.8% (n=5) and 62.6% (n=15), respectively and 16.7% (n=4) had not taken oral hypoglycemic agents or insulin prior to hospitalization. The incidence of stroke and atrial fibrillation was significantly higher in the patients with DM than in the non-diabetic patients with new-onset CAD (x2=7.353, p=0.028 and x2=8.040, p=0.017, respectively). In addition, the patients with DM had significantly higher Gensini scores (42.09±8.39 vs 35.4±3.069 [95% CI], p=0.036).
CONCLUSIONS Among the patients with new-onset CAD, the presence of DM was associated with higher cardiovascular morbidity and significantly greater severity of the coronary angiography findings. DM was correlated with multifocal distribution of atherosclerotic lesions and a greater degree of coronary artery luminal stenosis.
Key words: Coronary artery disease, Diabetes mellitus, Gensini score.