Diabetic CAD versus non diabetic CAD: a comparative study of clinical features, risk factors and angiographic profile

Abstract

Background: Current study was conducted to compare clinical, risk factor profile and angiographic features of diabetic and non diabetic patients with coronary artery disease.Methods: This case control study was carried out in 142 patients, who had angiographically proven CAD. 71 patients with diabetes or newly detected with diabetes constituted the cases and remaining controls. Necessary data was collected. Standard statistical analytics were used and risk factor and investigatory profile, including ECG, 2D ECHO and coronary angiography were compared between diabetic and non diabetic CAD patients.Results: Mean age of occurrence of CAD was 52.15+6.81, with no significant difference in mean age among groups. Higher prevalence of CAD was seen in female diabetics. Hypertension, dyslipidaemia, obesity and smoking were found as major risk factors of CAD. Atypical chest pain and silent ischemia were most common among diabetic CAD. Multiple vessel involvement (47.9% vs. 18.3%, p <0.01) is more common in diabetics. Prolonged duration of diabetes and poor glycemic control were associated with more severe and extensive form of CAD (p<0.05) and the treatment outcome in the form of CABG (p<0.01).Conclusions: Diabetic CAD patients were more likely to have severe, extensive coronary artery involvement. Significant number of diabetics had asymptomatic ischemia, with normal ECG and 2D echo, emphasizing the need of extensive cardiac evaluation at an early stage. Hypertension, dyslipidaemia, female gender along with uncontrolled and prolonged duration of diabetes, caused more critical form of CAD and poor treatment outcomes in the form of CABG.