Abstract

Background and Aims: Diabetic patients are at increased risk of developing coronary artery disease. This study was conducted with the aim to compare the extent and severity of coronary artery disease in patients with and without diabetes presenting with non ST segment elevation myocardial infarction (NSTEMI).
 Methods: This was a single center, hospital based, cross sectional, observational comparative study in which total 172 patients presenting with NSTEMI were divided into two groups of 86 patients each based on presence or absence of diabetes mellitus. Demographic, laboratory and angiographic data were analysed and compared between two groups.
 Results: Among 86 patients enrolled in each group demographic characteristics and risk profile were not significantly different except for smoking status. Significant number of non-diabetics were current smoker (26.7% vs. 9.3%; p < 0.01). Hypertension was the most common risk factor in both groups. Non-diabetic patients had significantly high single vessel disease when compared to diabetics (11.6% vs 24.4%; p=0.03) while multivessel disease was significantly higher among diabetics (80.2% vs 59.3%; p<0.01). Diabetics had severe coronary artery disease with significantly high Gensini score (71.18±39.03 vs 59.84±33.68; p=0.04). There was no difference in terms of type of vessel affected.
 Conclusions: Diabetic patients presenting with NSTEMI are likely to have more severe and extensive coronary artery disease compared to non-diabetic patients.

Highlights

  • The proportion of Non-ST segment elevation myocardial infarction (NSTEMI) in patients with acute coronary syndrome (ACS) has significantly increased in past decade.[1,2,3] Report from tertiary cardiac centre of Nepal showed that non ST segment elevation myocardial infarction (NSTEMI) constituted for 37.1% of all cases admitted for ACS.[4]

  • This study was conducted with the aim to compare the extent and severity of coronary artery disease in patients with and without diabetes presenting with non ST segment elevation myocardial infarction (NSTEMI)

  • Diabetic patients presenting with NSTEMI are likely to have more severe and extensive coronary artery disease compared to non-diabetic patients

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Summary

Introduction

The proportion of Non-ST segment elevation myocardial infarction (NSTEMI) in patients with acute coronary syndrome (ACS) has significantly increased in past decade.[1,2,3] Report from tertiary cardiac centre of Nepal showed that NSTEMI constituted for 37.1% of all cases admitted for ACS.[4]. This study was conducted with the aim to compare the extent and severity of coronary artery disease in patients presenting with NSTEMI based on diabetes status. Disease.[22] Smoking status was categorised in either of the following: current smoker defined as smoking cigarettes within 1 month of time of evaluation; recent smoker defined as stopped smoking cigarettes between 1 month and 1 year before evaluation; former smoker defined as stopped smoking cigarettes greater than 1 year before evaluation and never smoker defined as person who never smoked cigarettes.[23] Other clinical history and risk factor was defined according to American College of Cardiology Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients with Acute Coronary Syndrome.[23]

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