Key result
Young diabetic patients under 45 years with acute coronary syndrome more frequently present with atypical symptoms and a diffuse pattern of double vessel disease compared to non-diabetics.
Why the study?
The clinical presentation and angiographic findings of CAD vary by diabetic status and age, and CAD in patients below age 45 is a special subset where differing presentations influence management strategies.
Does diabetes mellitus alter the clinical presentation and angiographic profile in patients under 45 years with acute coronary syndrome?
Does diabetes mellitus alter the clinical presentation and angiographic profile in patients under 45 years with acute coronary syndrome?
Young patients under 45 with type 2 diabetes and ACS present atypically and have more diffuse, multi-vessel coronary disease compared to non-diabetics, highlighting the need for a higher index of suspicion and tailored management.
The clinical presentation and angiographic findings of coronary artery disease (CAD) varies from diabetic and non-diabetic patients and varies with the age of presentation. Coronary artery disease in patients below the age of 45 is a special subset. The objective of this study is to compare the clinical and angiographic profile in patients with the acute coronary syndrome (ACS) with diabetes mellitus (DM) and without DM below the age of 45 years. Clinical Presentation of coronary artery disease in young patients with various risk factors differs, which plays an important role in management strategies. This was conducted through internet search on PubMed and ProQuest database from 2000 to until 2019. Key words used for searching are acute coronary syndrome, young diabetics, and clinical, angiographic profile. An important exclusion criterion is studies which included type one diabetic patients. Totally 35 papers were reviewed. Pattern of involvement of coronary arteries as assessed by the coronary angiographic study is found to be different in younger CAD patients. Atypical clinical presentation and distinct angiographic finding are common in diabetics below the age of 45. In most of the studies single vessel disease (SVD) is the most common angiographic finding in young CAD and non-diabetics. While the diabetics showed the more diffuse pattern of double vessel disease (DVD).
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Narayanan et al. (2020) conducted a review in Acute coronary syndrome. Diabetes Mellitus vs. Non-diabetics was evaluated on Clinical presentation and angiographic findings. Young diabetic patients under 45 years with acute coronary syndrome more frequently present with atypical symptoms and a diffuse pattern of double vessel disease compared to non-diabetics.
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