ANGIOGRAPHIC COMPARISON OF EXTENT AND SEVERITY OF CORONARY ARTERY DISEASE BETWEEN DIABETIC AND NON DIABETIC PATIENTS

Abstract

Objective: To compare the severity and extent of coronary artery disease in type-2 diabetic and non-diabetic patients suffering from coronary artery disease.

Methodology: This cross sectional study was conducted at National Institute ofCardiovascular Disease, Karachi (NICVD) from 8th December 2005 to 7th June2006. Non probability convenience sampling was used. All patients withsuspected or known coronary artery disease who were planned for angiographyand revascularization were included. Patient with previous percutaneouscoronary intervention (PCI) and coronary artery bypass graft (CABG), knownvalvular heart disease and type 1 diabetics were excluded from study. Patientsangiograms were evaluated for lesions in coronary arteries, number of vesselinvolved and type of lesions.

Results: It was found that diabetic patients are more prone to severe disease ineach coronary artery. In diabetic patients severe disease was significantly higherin LAD (54.7% vs. 44%, p <0.01), RCA (61.3% vs. 36 %, p <0.002) and LeftCircumflex (60% vs. 36%, p <0.003). Diabetic patients were found to have moreextensive disease as compared to non diabetics, so multi vessel disease wasmore common in diabetics as compared to non diabetics (54.7% vs. 21.3 %, p <0.001) . It was found that Type C lesions were more common in diabetics (32.7%vs. 14.9 %, p <0.001 ). Diabetic patients were having more severe, multivesseland diffuse disease as compared to non diabetics.

Conclusion: Coronary artery disease is more aggressive in diabetic patientsusually involving more vessels, diffuse in nature, more severe and having morecomplicated lesions