Srinidhi S Hegde1, P Mallesh2, S M Yeli3, Veeranna M Gadad4, Giri Punja M5. 1. Senior Resident, Department of Medicine, MMC & RI , Mysore, India . 2. Professor & HOD, Department of Cardiology, SSIMS , Davanagere, India . 3. Honorary Professor, Department of Medicine, NIMHANS , Davanagere, India . 4. Resident, Department of Neurology, Ramaiah , Bangalore, India . 5. Post-Graduate, Department of Pathology, MMC & RI , Mysore, India .
Abstract
BACKGROUND: Cardiac adversity is by far the commonest cause of mortality in patients with diabetes. Cardiac involvement in diabetes commonly manifest as coronary artery disease (CAD). Definitive diagnosis,precise assessment and anatomic severity of CAD requires invasive diagnostic modality like coronary angiography. AIMS AND OBJECTIVES: To study angiographic extents, type of vessels, number of vessels, severity involving coronary artery and its branches in patients with acute coronary syndrome(ACS).Compare the same in diabetics and non diabetics with ACS. MATERIALS AND METHODS: Hundred patients with ACS,50 diabetics and 50 nondiabetics admitted in Bapuji Hospital ICCU attached to J.J.M. Medical College were selected randomly during a period of approximately one and half years formed the study group. RBS, FBS was done in all 100 pateints, HbA1c in all diabetics. All subjects with ACS were taken up for coronary angiography. STATISTICAL ANALYSIS: Chi-square test was used to determine any significant difference between two groups. p-value of less than 0.05 was considered significant. RESULTS: In our study 22 (44%) out of 50 diabetic patients had triple or multi-vessel disease compared to 8 (16%) out of 50 non diabetics. Hundred patients with ACS, number of vessels involved were 199, of which 61.3% in diabetics and 38.6% in non diabetics, 23(46%) of 50 diabetic patients required CABG as treatment outcome. HbA1c levels of >8.5%, 69.2% had triple / multi vessel disease and 19 (73.1%) of 23 patients who had to undergo CABG had HbA1c levels >8.5%, 24% of diabetics were in third decade, 40% were in fourth decade as compared to 10% and 26% of non-diabetics of similar age group. INTERPRETATION AND CONCLUSION: This study showed that ACS in diabetic patients presented much earlier in life, the severity and extent of CAD and incidence of triple/multi vessel disease was significantly high in diabetics when compared to nondiabetics with ACS. Diabetics with high HbA1c had more number of coronary vessel involvement and the mode of treatment required in them was CABG.
BACKGROUND: Cardiac adversity is by far the commonest cause of mortality in patients with diabetes. Cardiac involvement in diabetes commonly manifest as coronary artery disease (CAD). Definitive diagnosis,precise assessment and anatomic severity of CAD requires invasive diagnostic modality like coronary angiography. AIMS AND OBJECTIVES: To study angiographic extents, type of vessels, number of vessels, severity involving coronary artery and its branches in patients with acute coronary syndrome(ACS).Compare the same in diabetics and non diabetics with ACS. MATERIALS AND METHODS: Hundred patients with ACS,50 diabetics and 50 nondiabetics admitted in Bapuji Hospital ICCU attached to J.J.M. Medical College were selected randomly during a period of approximately one and half years formed the study group. RBS, FBS was done in all 100 pateints, HbA1c in all diabetics. All subjects with ACS were taken up for coronary angiography. STATISTICAL ANALYSIS: Chi-square test was used to determine any significant difference between two groups. p-value of less than 0.05 was considered significant. RESULTS: In our study 22 (44%) out of 50 diabeticpatients had triple or multi-vessel disease compared to 8 (16%) out of 50 non diabetics. Hundred patients with ACS, number of vessels involved were 199, of which 61.3% in diabetics and 38.6% in non diabetics, 23(46%) of 50 diabeticpatients required CABG as treatment outcome. HbA1c levels of >8.5%, 69.2% had triple / multi vessel disease and 19 (73.1%) of 23 patients who had to undergo CABG had HbA1c levels >8.5%, 24% of diabetics were in third decade, 40% were in fourth decade as compared to 10% and 26% of non-diabetics of similar age group. INTERPRETATION AND CONCLUSION: This study showed that ACS in diabeticpatients presented much earlier in life, the severity and extent of CAD and incidence of triple/multi vessel disease was significantly high in diabetics when compared to nondiabetics with ACS. Diabetics with high HbA1c had more number of coronary vessel involvement and the mode of treatment required in them was CABG.
Authors: José Marconi Almeida de Sousa; João L V Herrman; Marco Teodoro; Sergio Diogo; Bernardino Bandeira Terceiro; Angelo Amato Vincenzo de Paola; Antonio Carlos Camargo Carvalho Journal: Arq Bras Cardiol Date: 2006-02-20 Impact factor: 2.000
Authors: P Henry; S Makowski; P Richard; F Beverelli; S Casanova; A Louali; K Boughalem; S Battaglia; L Guize; J L Guermonprez Journal: Am Heart J Date: 1997-12 Impact factor: 4.749
Authors: Stephen J Nicholls; E Murat Tuzcu; Srinivasa Kalidindi; Kathy Wolski; Keon-W Moon; Ilke Sipahi; Paul Schoenhagen; Steven E Nissen Journal: J Am Coll Cardiol Date: 2008-07-22 Impact factor: 24.094
Authors: Jamal S Rana; Allison Dunning; Stephan Achenbach; Mouaz Al-Mallah; Matthew J Budoff; Filippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Victor Y Cheng; Kavitha Chinnaiyan; Benjamin J W Chow; Ricardo Cury; Augustin Delago; Gudrun Feuchtner; Martin Hadamitzky; Jörg Hausleiter; Philipp Kaufmann; Ronald P Karlsberg; Yong-Jin Kim; Jonathon Leipsic; Troy M Labounty; Fay Y Lin; Erica Maffei; Gilbert Raff; Todd C Villines; Leslee J Shaw; Daniel S Berman; James K Min Journal: Diabetes Care Date: 2012-06-14 Impact factor: 19.112
Authors: Milo Engoren; Robert H Habib; Anoar Zacharias; Thomas A Schwann; Christopher J Riordan; Samuel J Durham; Aamir Shah Journal: J Cardiothorac Surg Date: 2008-11-24 Impact factor: 1.637