Key result
Diabetes mellitus is linked to more severe CAD and multivessel disease in ACS.
Why the study?
Diabetes mellitus is a major risk factor for ischemic heart disease and impacts the extent and severity of coronary artery disease in acute coronary syndrome patients.
Does diabetes mellitus affect the angiographic profile in patients with acute coronary syndrome?
Observational (n=298)
No
Does diabetes mellitus affect the angiographic profile in patients with acute coronary syndrome?
Absolute Event Rate: 56.4% vs 43.6%
p-value: p=<0.001
Patients with diabetes mellitus presenting with acute coronary syndrome have more severe and extensive coronary artery disease, including higher rates of three-vessel and left main disease, compared to non-diabetics.
May inform risk stratification in diabetic ACS; leaves open whether profiles alter management or prognosis.
Background: Cardiovascular diseases are the leading cause of death worldwide while ischemic heart disease is a major contributor of cardiovascular diseases and diabetes mellitus is one of the major risk factor for ischemic heart diseases. Cardiac involvement in diabetes commonly manifest as coronary artery disease (CAD) of different extent which has an impact on disease outcome and prognosis. Aim: To compare the angiographic profiles between diabetic and non-diabetic patients with acute coronary syndrome (ACS). Place and duration of study: National Institute of Cardiovascular Diseases, Karachi, Pakistan from 1st Feb. 2020 to 31st Jan. 2021. Methodology: Two hundred and ninety eighty patients with acute coronary syndrome were enrolled. Demographic profile, personal and family history was taken through questioner. Angiography was performed to assess the angiographic profile in terms of extent of the disease, left main disease (LMD) involvement, severity of disease, and localization of disease to see the association with variables. Results: The mean age was 56.38±8.90 years and 240 (81%) were males and 58 (19%) were females. The diabetic patients have higher frequency of three vessels involved, localization of left anterior descending (LAD) and right coronary artery (RCA) with significant difference (p<0.0001 respectively). Left main disease was noted in 21 (25.3%) of diabetic participants and severe disease was found among 119 (56.4%) of diabetic participants with significant difference compared to non-diabetics (p<0.001). Angiographic profile was also found to be significantly different among hypertensive and non-hypertensive participants (p<0.05) Conclusion: There is higher frequency of diabetes in patients with ACS and most of them are male. While severity of disease, involvement of RCA and LAD in patients with acute coronary syndrome is quite high in patients with diabetes mellitus as compared to non-diabetic patients. Hypertension was also found to be associated with angiographic profile.
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Ahmed et al. (2022) conducted an observational in Acute coronary syndrome (n=298). Diabetes Mellitus vs. Non-diabetic patients was evaluated on Severe coronary artery disease (p=<0.001). Diabetes mellitus was associated with a significantly higher frequency of severe coronary artery disease and three-vessel involvement in patients presenting with acute coronary syndrome.
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