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Abstract

A Comparative Angiographic Severity of Coronary Artery Disease in Diabetic and Non Diabetics in a Tertiary Cardiac Centre

Introduction: Diabetes is a major risk factor for various cardiovascular diseases including coronary artery disease. Coronary atherosclerosis is not only more prevalent in diabetic patients but is also more severe. Diabetics are more prone to multi vessel involvement as well as associated with poor outcomes to acute coronary events.

Methods: This is a hospital based descriptive cross-sectional study including 300 patients (diabetic and non-diabetic) undergoing coronary angiography at Sahid Gangalal National Heart Centre over a period of one year (January to December 2016).

Results: Out of the total 300 patients studied at angiography, majority (68.3%, 205 patients) were male with the age group ranging from 29 to 86 years of age. Significant number of diabetics had associated risk factor as hypertension (88%) as the most common. Brahmins and Madhesi (27% each) ethnic group of origin formed the major group studied. Significant coronary artery disease defined as >50 % stenosis was evident in 118 patients (78.7%) among diabetics whereas it was present in 99 patients (66%, p value 0.01, significant). Maximum number of diabetic patients had presence of triple vessel disease ( 52 patients, 34.7 %) followed by double vessel and single vessel disease ( 25.3 % and 18.7 %) respectively as well as more number of diffuse vessel disease (28 % ,p value 0.006 ) . The mean Gensini score studied was 33.07±28.7 with the highest Gensini score of 126. Diabetic group of patients had a higher Gensini scores (37.2 ± 28.4) as compared to non-diabetic (28.9 ± 28.6, p value <0.05).

Conclusion: Diabetic patients had higher total Gensini scores at angiogram which reflect greater severity of coronary artery disease as compared to non-diabetics as well as higher incidence of triple vessel disease and diffuse coronary artery disease.


Author(s):

Hirachan A*, Maskey A, Sharma R, Neupane P, Bhattarai M, Hirachan GP and Adhikari J



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