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Category: Volume 06 Issue 08 August 2018
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Title: Coronary Angiographic (CAG) Findings between Diabetic and non diabetic Patients in Coronary artery disease: A Comparative Study

Authors: Dr Rajiv Girdhar, Dr Yogesh Kothari, Dr Anuj Sanjay Kamat, Dr Ram Anil Raj, Dr Bryan Jacob Koithara

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.126

Abstract

Introduction: Coronary artery disease (CAD) accounts for the major chunk of mortality in diabetes. Coronary angiography or arteriography remains the “gold-standard” technique for diagnosing and evaluating CAD.

Material and Methods: The present study was undertaken at Rajarajeswari Medical College and  Hospital, Bangalore , India  between the periods of 1ST December- 2016 to  31st June -2018.

Percutaneous coronary angiography (CAG) was Performed in 200 consecutive patients with suggestive of ischaemic chest pain. The population consisted of of which 75 cases are diabetic  and 125 cases are non-diabetic

Results: We observed positive angiographic lesion among both groups comparing site & number of vessel(s) involvement also average percentage of stenosis. The presence of coronary risk factors was not significantly different between the two populations. Total positive angiographic lesion was 131 (65.5%) in both groups. Among the Diabetes mellitus patients positive CAG finding 61 (81.33%).The recognized lesions were single vessel disease (SVD) 16 (26.24),double vessel disease (DVD) 25 (40.98%), triple vessel disease (TVD) 20 (32.78%), diffuse lesions 6 (9.8%) and average vessel stenosis 82.63%. On the other hand, total positive angiographic lesion was 70 (56%) in non--diabetic group; among them single vessel disease (SVD) 23 (32.85%), double vessel disease (DVD) 28(40%), triple vessel disease (TVD) 19 (27.15%), no diffuse lesions was found and average vessel stenosis was 78.03%. The results of the angiographic finding suggest that diabetic patients have a higher incidence of coronary heart disease (CHD), DVD, TVD, diffuse lesion & marked stenosis of coronary vessel than nondiabetic patient.

Conclusion: CAD in diabetics had considerably higher percent of severe and unpredictable presentation. This increased frequency of complex lesion morphology is more difficult to treat by definitive intervention like percutaneous transluminal coronary angioplasty (PCI) & coronary artery bypass graft (CABG). Diabetics have a higher risk factor profile and poor clinical outcome. Early diagnosis and appropriate management will reduce the risk of complication after the onset of disease.

Keywords: Coronary artery disease, Coronary angiogram, Diabetes mellitus, Non –diabetics.

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Corresponding Author

Dr Rajiv Girdhar

DM Cardiology PG, Rajarajeswari Medical College and Hospital,

Mysore Road, Bangalore 560074, India