Key result
Diabetes linked to ~45% higher prevalence of positive angiographic lesions and more complex coronary involvement.
Why the study?
Coronary artery disease accounts for major mortality in diabetes, but comparative coronary angiographic findings between diabetic and non-diabetic patients were not well characterized.
Do diabetic patients have more severe coronary angiographic findings compared to non-diabetic patients presenting with ischaemic chest pain?
Cross-Sectional (n=200)
No
Do diabetic patients have more severe coronary angiographic findings compared to non-diabetic patients presenting with ischaemic chest pain?
Answers are grounded in this paper and cite their sources.
Diabetic patients presenting with ischemic chest pain have significantly more complex and severe coronary artery disease on angiography compared to non-diabetics.
Introduction: Coronary artery disease (CAD) accounts for the major chunk of mortality in diabetes.Coronary angiography or arteriography remains the "gold-standard" technique for diagnosing and evaluating CAD.Material and Methods: The present study was undertaken at Rajarajeswari Medical College and Hospital, Bangalore , India between the periods of 1 ST December-2016 to 31 st June -2018.Percutaneous coronary angiography (CAG) was Performed in 200 consecutive patients with suggestive of ischaemic chest pain.The population consisted of of which 75 cases are diabetic and 125 cases are nondiabetic Results: We observed positive angiographic lesion among both groups comparing site & number of vessel(s) involvement also average percentage of stenosis.The presence of coronary risk factors was not significantly different between the two populations.Total positive angiographic lesion was 131 (65.5%) in both groups.Among the Diabetes mellitus patients positive CAG finding 61 (81.33%).The recognized lesions were single vessel disease (SVD) 16 (26.24),doublevessel disease (DVD) 25 (40.98%),triple vessel disease (TVD) 20 (32.78%), diffuse lesions 6 (9.8%) and average vessel stenosis 82.63%.On the other hand, total positive angiographic lesion was 70 (56%) in non--diabetic group; among them single vessel disease (SVD) 23 (32.85%), double vessel disease (DVD) 28(40%), triple vessel disease (TVD) 19 (27.15%), no diffuse lesions was found and average vessel stenosis was 78.03%.The results of the angiographic finding suggest that diabetic patients have a higher incidence of coronary heart disease (CHD), DVD, TVD, diffuse lesion & marked stenosis of coronary vessel than nondiabetic patient.Conclusion: CAD in diabetics had considerably higher percent of severe and unpredictable presentation.This increased frequency of complex lesion morphology is more difficult to treat by definitive intervention like percutaneous transluminal coronary angioplasty (PCI) & coronary artery bypass graft (CABG).Diabetics have a higher risk factor profile and poor clinical outcome.Early diagnosis and appropriate management will reduce the risk of complication after the onset of disease.
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Dr Rajiv Girdhar (2018) conducted a cross-sectional in Coronary artery disease (n=200). Diabetes mellitus vs. Non-diabetic was evaluated on Positive angiographic lesion (coronary artery stenosis ≥ 50%). Diabetes mellitus was associated with a higher prevalence of positive angiographic lesions (81.33% vs 56%) and more severe, complex coronary vessel involvement compared to non-diabetic patients.
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