ANGIOGRAPHIC COMPARISON OF EXTENT AND SEVERITY OF CORONARY ARTERY DISEASE BETWEEN DIABETIC AND NON DIABETIC PATIENTS

Objective: To compare the severity and extent of coronary artery disease in type-2 diabetic and non-diabetic patients suffering from coronary artery disease. Methodology: This cross sectional study was conducted at National Institute of Cardiovascular Disease, Karachi (NICVD) from 8th December 2005 to 7th June 2006. Non probability convenience sampling was used. All patients with suspected or known coronary artery disease who were planned for angiography and revascularization were included. Patient with previous percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG), known valvular heart disease and type 1 diabetics were excluded from study. Patients angiograms were evaluated for lesions in coronary arteries, number of vessel involved and type of lesions. Results: It was found that diabetic patients are more prone to severe disease in each coronary artery. In diabetic patients severe disease was significantly higher in LAD (54.7% vs. 44%, p < 0.01), RCA (61.3% vs. 36 %, p < 0.002) and Left Circumflex (60% vs. 36%, p < 0.003). Diabetic patients were found to have more extensive disease as compared to non diabetics, so multi vessel disease was more common in diabetics as compared to non diabetics (54.7% vs. 21.3 %, p < 0.001). It was found that Type C lesions were more common in diabetics (32.7% vs. 14.9 %, p < 0.001). Diabetic patients were having more severe, multivessel and diffuse disease as compared to non diabetics. Conclusion: Coronary artery disease is more aggressive in diabetic patients usually involving more vessels, diffuse in nature, more severe and having more complicated lesions.