Coronary artery disease severity and risk factors in diabetic patients

Abstract

Traditional cardiovascular risk factors CVRF's are well recognised for their association with atherosclerotic CAD. However the relationship between CVRF's and severity of atherosclerotic burden in diabetic patients assessed angiographically is not well established. This study aimed to assess the relationship between cardiovascular risk factors and the severity of coronary artery disease (CAD) in diabetic patients. We prospectively enrolled 220 diabetic patients who underwent coronary angiography. Disease severity was determined from the results of coronary angiography based on the presence or absence of multiple (two or three) diseased vessels and the SYNTAX score which allocates a numerical value for the degree of coronary stenosis severity. In the studied population (135 men and 85 women, mean age 64.7 ± 12.4 years). dyslipidaemia, hypertension and abdominal obesity were the most frequent modifiable cardiovascular risk factor, present in 40.9, 55.8 and 33.7% of patients, respectively. Multiple logistic regression analysis showed that glycated hemoglobin HBA1c level, ratio of total to HDL cholesterol and abdominal obesity significantly increased the risk of multivessel CAD: odds ratios (ORs) of 2.19 (1.15–2.35; P = 0.039), 1.82 (1.13–1.99; P = 0.032) and 1.76 (1.23–2.67; P = 0.009), respectively. In contrast other traditional CRFs (hypertension, age and family history of vascular disease) were not associated with CAD severity. A significant linear correlation was also noted between HBA1c level and the syntax score.(p:0.001, r:0.541) Among diabetic patients underwent coronary angiography; HBA1c, abdominal obesity and dyslipidemia are significantly associated with the severity of CAD.