Key result
Diabetic patients with coronary artery disease had a significantly higher mean SYNTAX score (18.77 vs 13.16) and a greater prevalence of triple vessel disease and total occlusions compared to non-diabetics.
Why the study?
Cardiac involvement manifesting as CAD is a leading cause of morbidity and mortality in diabetes, requiring evaluation of its extent and anatomic severity using the Syntax score.
Does diabetes increase the severity of coronary artery disease as measured by Syntax score in patients undergoing coronary angiography for acute or chronic coronary syndrome?
Case-Control (n=200)
No
Does diabetes increase the severity of coronary artery disease as measured by Syntax score in patients undergoing coronary angiography for acute or chronic coronary syndrome?
Absolute Event Rate: 18.77% vs 13.16%
p-value: p=<0.001
Diabetic patients presenting with coronary syndromes have significantly more complex and severe coronary artery disease, including higher Syntax scores and more triple vessel disease, compared to non-diabetics.
Diabetics with CAD show greater complexity; cross-sectional data leaves open causal links and tailored strategies.
Abstact: Background: Cardiac involvement is one of the commonest causes of morbidity and mortality in patients with diabetes. It manifest as coronary artery disease. Definitive diagnosis, precise assessment of CAD requires invasive diagnostic modality like conventional coronary angiography and its anatomic severity can be judged by Syntax score. Aims and objectives: 1) Extent and severity of coronary artery disease with reference to Syntax score between diabetics Vs Non diabetics. 2) Correlation between fasting glucose, Glycated Hemoglobin (Hb A1c),TC/HDL-C ratio, BMI (body mass index) and severity of coronary artery disease. Materials and methodology: 200 patients (100 Diabetics and 100 Non diabetics) after meeting inclusion and exclusion criteria, admitted with symptoms of acute or chronic coronary syndrome, scheduled to undergo coronary angiogram were taken. Results: In our study duration of diabetes and severity of coronary artery disease was not correlating but as compared to non-diabetics,diabetics had higher syntax score, 23-32 30(30%) were diabetics, while 13(13%)were nondiabetics, and score>33 9, (9%) diabetics as compared to nondiabetic has 1%,p value<0.001. Diabetics have more numbers of TVD (Triple Vessel Disease) 52% as compared to nondiabetics 12%, p value<0.001. Diabetics had more numbers of Total occlusion of vessel (p=0.027), Calcification (p=0.003), Proximal vessel involvement, (p=0.000), CTO (chronic total occlusion), p=0.027 and diffusely disease vessels (p=0.000), as compared to nondiabetics. Biochemical parameters like FBS, HbA1c and clinical parameters like BMI and Hypertension were not correlating with severity of coronary artery disease. In controls age is highly correlated with severity of coronary artery disease with correlation coefficient of 0.363 (p value=0.0001) whereas in cases TC/HDL is highly correlated with severity of coronary artery disease with correlation coefficient of 0.205 (p value 0.041). Conclusion: Diabetics have more numbers of Total vessel occlusion, CTOs, Proximal vessel involvement, calcifications and diffuse CAD.TC/HDL is better parameter to predict severity of CAD.
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Tejas Shah (2020) conducted a case-control in Coronary Artery Disease (n=200). Diabetes mellitus vs. Non-diabetic was evaluated on Mean SYNTAX score (p=<0.001). Diabetic patients with coronary artery disease had a significantly higher mean SYNTAX score (18.77 vs 13.16) and a greater prevalence of triple vessel disease and total occlusions compared to non-diabetics.
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