A comparative study of angiographic severity of coronary artery disease in diabetic and non- diabetic patients with acute coronary syndrome by Gensini scoring system

摘要

Background: There is enough evidence that the presence of diabetes increases the risk of clinical atherosclerotic disease from twofold to threefold, with coronary artery disease (CAD) as its chief sequelae. So the present study is conducted in order to compare the severity of CAD between diabetic and non-diabetic group of patients with acute coronary syndrome by using Gensini scoring system.Aim of the study: To study the Type of vessels, Number of vessels, severity of lesions involving coronary artery and its branches in patients with ACS and to compare the involvement in diabetic and non-diabetic patients with ACS by Gensini scoring system.Materials and methods: 144 Patients (72 diabetics and 72 non diabetics) with acute Coronary Syndrome diagnosed on Clinical, ECG and or/ Cardiac enzyme levels and admitted in ICCU of KIMS Hospital, Hubli, and undergoing coronary angiography during the study period were taken in the study considering the inclusion and exclusion criteria. Each patient was evaluated with History, clinical examination, and lab investigations which included: Electrocardiogram, 2D-ECHO, Coronary angiography, HbA1c, Lipid profile and Renal function test. Based on angiographic findings, coronary artery disease severity was calculated using Gensini, and the data obtained was analysed by different statistical methods.Results: Out of 144 patients, ACS was commoner among males than females (72.9% vs 27.1%) and age of presentation was earlier in males compared to females (53yrs vs 58yrs). Multi vessel disease was commoner in diabetics compared to non diabetics (52.8% vs 15.3%) and also means Gensini score was higher in diabetics (45.2 vs 19.2).Conclusion: From this study we can conclude that diabetic patients with ACS have more severe coronary disease with respect to higher number of vessels involved, more severe of occlusion and higher Gensini score and also severity increases with the duration of diabetes and poorglycemic control.