Clinical and Angiographic Findings in Diabetic Versus Non-Diabetic Iraqi Patients with Ischemic Heart Disease (A Single Center Experience)


ABSTRACT:BACKGROUND:Diabetes mellitus (DM) is a common, chronic and complex metabolic disorder. Its direct and indirect effects on the vascular system are major causes of morbidity and mortality.OBJECTIVE:To verify the effects of diabetes mellitus on clinical presentation and angiographic findings in diabetic patients with ischemic heart disease as compared to non diabetic patients.PATIENTS AND METHODS:This cross-sectional descriptive study was conducted in the Iraqi Center of Heart Diseases during the period from November 2008 till June 2009. Two-hundred patients with ischemic heart disease (IHD) who were referred to the Iraqi Center for Heart Diseases were randomly included. Clinical history and examination were done; blood tests, electrocardiography and echocardiography were done for all patients. Patients were classified into 2 groups: 68 patients with diabetes mellitus and 132 patients without diabetes mellitus. Coronary angiography was done for all patients and the results were interpreted by two independent interventional cardiologists.RESULTS :There were 145 (72.5 %) males and 55 (27.5 %) females. The mean age of study population was 56.92 ± 3.9 years (56.57 ± 3.2 years for males, 57.91 ± 4.1 years for females).There were no statistically significant differences between diabetic and diabetic patients regarding sex, age, type of clinical presentation, presence of hypertension and family history of coronary heart disease. Diabetic patients were more likely to be smoker (61.7% vs. 48.4%, P = 0.01), to have dyslipidemia (53% vs. 35%, P = 0.03), left ventricular systolic dysfunction (61.7% vs. 48.4%, P = 0.045) left ventricular diastolic dysfunction (92.6% vs. 58.3%, P =0.03), more diseased coronary arteries (38.2% vs. 25.7%, P =0.009), more frequent left main stem involvement (13.2% vs. 3.8%, P =0.008) and more complex coronary lesions (60.2% vs 31.8%, P =0.00002).CONCLUSION:Diabetic mellitus has clear adverse effects on left ventricular systolic and diastolic functions and angiographic findings in patients with ischemic heart disease