Determination of Correlation between Diabetes Duration and Coronary Artery Disease Severity in Patients Undergoing Coronary Angiography

DOI: https://doi.org/10.30702/ujcvs/24.32(02)/IA020-4550
Keywords: atherosclerosis, modified Gensini score, cardiovascular disease, comorbidity

Abstract

Background. Coronary artery disease (CAD) is caused by atherosclerotic process in coronary arteries. Due to extraordinary risk for atherosclerosis in diabetic patients, it is also counted as a vascular disease. Diabetes mellitus (DM) is a direct major associated risk factor in the development of cardiovascular disease with some studies from high income countries reporting correlation between duration of DM and severity of CAD. However, data from Pakistan is scarce.

The aim. To determine the correlation between duration of DM and severity of CAD in patients undergoing coronary angiography at the tertiary care cardiac center.

Materials and methods. This cross-sectional study was conducted in the Department of Cardiology, Civil Hospital Karachi, among 160 patients who were scheduled for coronary angiography with comorbid DM. Correlation between duration of DM and severity of CAD (as assessed by the modified Gensini score) was statistically measured and reported employing Pearson’s correlation coefficient (r).

Results. Significant correlation between DM duration and total Gensini score was shown with r = 0.759 and p = 0.000001. With the increase in the duration of DM, the severity of CAD also increased.

Conclusion. DM duration is positively associated with the modified Gensini score and the significant determinants of CAD severity tend to be relevant.

References

  1. Shahjehan RD, Bhutta BS. Coronary Artery Disease. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564304
  2. Ul Amin R, Ahmedani MAM, Karim M, Raheem A. Correlation between Gensini Score and Duration of Diabetes in Patients Undergoing Coronary Angiography. Cureus. 2019 Feb 4;11(2):e4010. https://doi.org/10.7759/cureus.4010
  3. Wang KY, Zheng YY, Wu TT, Ma YT, Xie X. Predictive Value of Gensini Score in the Long-Term Outcomes of Patients With Coronary Artery Disease Who Underwent PCI. Front Cardiovasc Med. 2022 Jan 24;8:778615. https://doi.org/10.3389/fcvm.2021.778615
  4. Arredondo A. Diabetes duration, HbA1c, and cause-specific mortality in Mexico. Lancet Diabetes Endocrinol. 2018;6(6):429-431. https://doi.org/10.1016/S2213-8587(18)30098-6
  5. Saleem T, Mohammad KH, Abdel-Fattah MM, Abbasi AH. Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease. Diab Vasc Dis Res. 2008;5(3):184-189. https://doi.org/10.3132/dvdr.2008.030
  6. Casanova F, Adingupu DD, Adams F, Gooding KM, Looker HC, Aizawa K, et al. The impact of cardiovascular co-morbidities and duration of diabetes on the association between microvascular function and glycaemic control. Cardiovasc Diabetol. 2017 Sep 15;16(1):114. https://doi.org/10.1186/s12933-017-0594-7
  7. Che J, Li G, Wang W, Li Q, Liu H, Chen K, et al. Serum autoantibodies against human oxidized low-density lipoproteins are inversely associated with severity of coronary stenotic lesions calculated by Gensini score. Cardiol J. 2011;18(4):364-370.
  8. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017;128:40-50. https://doi.org/10.1016/j.diabres.2017.03.024
  9. Ma CX, Ma XN, Guan CH, Li YD, Mauricio D, Fu SB. Cardiovascular disease in type 2 diabetes mellitus: progress toward personalized management. Cardiovasc Diabetol. 2022 May 14;21(1):74. https://doi.org/10.1186/s12933-022-01516-6
  10. Ayça B, Kafadar D, Avsar M, Avci Iİ, Akın F, Okuyan E, et al. Lower Muscle Strength and Increased Visceral Fat Associated With No-reflow and High Gensini Score in STEMI. Clin Appl Thromb Hemost. 2017;23(4):367-373. https://doi.org/10.1177/1076029615613159
  11. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4-14. https://doi.org/10.1016/j.diabres.2009.10.007
  12. Xuan YL, Wang Y, Xue M, Hu HS, Cheng WJ, Li XR, et al. In rats the duration of diabetes influences its impact on cardiac autonomic innervations and electrophysiology. Auton Neurosci. 2015;189:31-36. https://doi.org/10.1016/j.autneu.2015.01.003
  13. Avci A, Fidan S, Tabakçı MM, Toprak C, Alizade E, Acar E, et al. Association between the Gensini Score and Carotid Artery Stenosis. Korean Circ J. 2016;46(5):639-645. https://doi.org/10.4070/kcj.2016.46.5.639
  14. Saad MI, Abdelkhalek TM, Saleh MM, Kamel MA, Youssef M, Tawfik SH, et al. Insights into the molecular mechanisms of diabetes-induced endothelial dysfunction:focus on oxidative stress and endothelial progenitor cells. Endocrine. 2015;50(3):537-567. https://doi.org/10.1007/s12020-015-0709-4
  15. Badimon L, Chagas P, Chiva-Blanch G. Diet and Cardiovascular Disease: Effects of Foods and Nutrients in Classical and Emerging Cardiovascular Risk Factors. Curr Med Chem. 2019;26(19):3639-3651. https://doi.org/10.2174/0929867324666170428103206
  16. Salim MM, Nesa MFT, Arif RM, Delwar HM, Masum MMR. Association of Glycosylated Haemoglobin level with the severity of Coronary Artery Disease in NSTEMI Diabetic patients. Cardiovascular journal. 2015;8(1):43-48. https://doi.org/10.3329/cardio.v8i1.24767
  17. Malthesh MK, Sakib TMM, Mallesh P. Coronary Artery Involvement in Diabetic and Non-diabetic Patients with Acute Coronary Syndrome. Int J Sci Study. 2016;3(12):299-302. https://doi.org/10.17354/ijss/2016/169
  18. Almutairi NM, Alahmadi S, Alharbi M, Gotah S, Alharbi M. The Association Between HbA1c and Other Biomarkers With the Prevalence and Severity of Diabetic Retinopathy. Cureus. 2021;13(1):e12520. https://doi.org/10.7759/cureus.12520
  19. Jafar TH, Qadri Z, Chaturvedi N. Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men. Heart. 2008;94(4):408-13. https://doi.org/10.1136/hrt.2007.120774
  20. Nowbar AN, Gitto M, Howard JP, Francis DP, Al-Lamee R. Mortality From Ischemic Heart Disease: Analysis of Data From the World Health Organization and Coronary Artery Disease Risk Factors From NCD Risk Factor Collaboration. Circ Cardiovasc Qual Outcomes. 2019 Jun;12(6):e005375. https://doi.org/10.1161/CIRCOUTCOMES.118.005375
  21. Baumann AAW, Mishra A, Worthley MI, Nelson AJ, Psaltis PJ. Management of multivessel coronary artery disease in patients with non-ST-elevation myocardial infarction: a complex path to precision medicine. Ther Adv Chronic Dis. 2020 Jul 1;11:2040622320938527. https://doi.org/10.1177/2040622320938527
  22. Hegde SS, Mallesh P, Yeli SM, Gadad VM, M GP. Comparitive Angiographic Profile in Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome. J Clin Diagn Res. 2014;8(9):MC07-MC10. https://doi.org/10.7860/JCDR/2014/9072.4851
  23. Coventry P, Lovell K, Dickens C, Bower P, Chew-Graham C, McElvenny D, et al. Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease. BMJ. 2015 Feb 16;350:h638. https://doi.org/10.1136/bmj.h638
  24. Guerrero-Fernández de Alba I, Orlando V, Monetti VM, Mucherino S, Gimeno-Miguel A, Vaccaro O, et al. Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients. Front Pharmacol. 2020 Nov 30;11:586187. https://doi.org/10.3389/fphar.2020.586187
Published
2024-06-27
How to Cite
Imam, H., Ahmed, F., Muhammad, S., Babar, B., Shah, A. A., Shah, S. D. A., & Lashari, M. N. (2024). Determination of Correlation between Diabetes Duration and Coronary Artery Disease Severity in Patients Undergoing Coronary Angiography. Ukrainian Journal of Cardiovascular Surgery, 32(2), 45-50. https://doi.org/10.30702/ujcvs/24.32(02)/IA020-4550
Issue
Ukrainian Journal of Cardiovascular Surgery Vol 32 No 2 2024
Section
ISCHEMIC HEART DISEASE