Evaluating coronary artery disease in type 2 diabetes mellitus and Other Risk Factors by angiographic study

Abstract

Background: Diabetes mellitus (DM) is a metabolic and vascular illness associated with two to four times coronary artery disease (CAD) events and mortality which correlate well with fasting, postprandial plasma glucose and HbA1c level. Other factors such as aging, gender, smoking, dyslipidaemia and hypertension also play an important role in diabetic micro- and macro-vascular complications. Type 2 DM is reported now to be CAD equivalent.
Patients and Methods: A cross sectional study of 118 patients including 90 males and 28 females being 63 diabetics and 55 non-diabetics over the period from March-November 2007 in Iraqi center for cardiac diseases who were underwent coronary angiographic study.
Results: By angiographic study CAD was present in 92.1% of diabetic versus 89.1% in non diabetic patients. Single, double and triple vessels diseases were found in 15.9%, 22.2%, and42.9% of diabetics versus 16.4%, 21.8%, 34.5% in non diabetics respectively. DM and dyslipidaemias were proved to be independent risk factors for left circumflex artery (LCX) disease predilection (p value <0.05).
Conclusion: Type 2 DM and female gender were reported to be independent risk factors for LCX and left main stem coronary arteries respectively while age, smoking, and dyslipidaemia were independent risk factors for coronary atherosclerotic . Hypertension and family history were proven to be dependent atherosclerotic risk factors and this may suggest that risk factors for the presence of CAD may differ from those affecting angiographic extent and severity. CAD was more extensive and severe in post menopausal women in this study.