Bhat, M.N.

Bhat, R.U.

Kamath, P.K.

Kamath, R.L.

Pai, N.D.

Shah, T.D.

Vekariya, R.S.

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Correlation of duration of diabetes with severity of coronary artery disease in patients with type 2 Diabetes Mellitus 

T.D. Shah

R.S. Vekariya

R.L. Kamath

M.N. Bhat

N.D. Pai

R.U. Bhat

P.K. Kamath

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Indian Heart Journal

Correlation of duration of diabetes with severity of coronary artery disease in patients with type 2 Diabetes Mellitus

Conclusion: In conclusion, our findings suggest that the CHADS2,
CHA2DS2-VASc, and especially CHA2DS2-VASc-HS and CHA2DS2-
VASc-HSF scores could be consideredpredictive of the risk of severe
CAD. The risk scoring systems may play an important role as pre-
dictivemodels because they are simple and can be easily applied by
physicians without any additional costs in routine practice.
Assessment of levels of apolipoproteins in
patients of coronary artery diseases
Ranjan Modi, S.V. Patted, P.C. Halkati
KLES University and MRC, Belgaum, India
Introduction: Although abnormal serum Lipid profile has been
considered to be an important risk factor for development of
Coronary Artery Disease, there are significant numbers of patients
who have normal lipid profile and yet develop CAD. Recently
Apolipoproteins B, Apolipoproteins A and their ratio have been
shown to be better predictor of risk of developing Coronary artery
disease as compared to conventional Lipid profile.
Objective: The aim of this study was to assess the levels of Apo-
lipoproteins B and A in patients of CAD with normal lipid profile
on lipid lowering therapy.
Materials and Methods: A one year cross sectional study on 1000
patients admitted in KLES Dr.PKH and MRC, Belgaumwith history
suggestive of Ischemic heart disease. Routine investigations
including conventional Lipid profile, apo b and apo a levels and
coronary angiography were done for all.
Results: Out of 1000 patients 880 (88%) patients had abnormal apo
b / apo a ratio. In these patients normal coronaries were seen in 90
patients whereas 790 had CAD on angiography. Out of 870 patients
with normal total cholesterol levels (<200mg%), 780 had abnormal
apob/apoa ratio of which 730 (91%) had CAD. Of 690 patients with
normal LDL levels (<100 mg), 580 patients had abnormal apob/
apoa ratio of which 520 (91%) had CAD. In 460 patients on lipid
lowering agents 430 had abnormal apo b/ apo a ratio with all of
them (100%) having CAD.
Conclusion: This study ascertains the importance of apolipopro-
teins b and a and their ratio in relation to CAD. It substantiates the
significance of the apob/apoa ratio over conventional lipid profile
values for predicting CAD and its severity. Association of Apo B/
Apo A ratio and CAD in patients with history of dyslipidemia on
lipid lowering agents was found significant. This study has shown
that statins have been effective in lowering LDL, but have not
shown commensurate changes in Apo B levels. Measurement of
Apo B and Apo A should be added to the routine lipid profile
assessment in order to know the atherogenic potential of lipid
disorders in a particular case.
Correlation of duration of diabetes with severity of
coronary artery disease in patients with type 2
Diabetes Mellitus
T.D. Shah, R.S. Vekariya, R.L. Kamath, M.N. Bhat, N.D. Pai,
R.U. Bhat, P.K. Kamath
Department of Cardiology, Kasturba Medical College, Mangalore, India
Background: To find out whether there is significant correlation
between duration of type 2 diabetes mellitus and severity of cor-
onary artery disease.
Methods: 100, type 2 diabetic and 100 non-diabetic subjects after
meeting inclusion and exclusion criteria, admitted with symp-
toms of acute or chronic coronary syndrome, scheduled to un-
dergo coronary angiogram were taken in this cross sectional
study. Risk factors like BMI, hypertension, smoking, fasting sugar,
HbA1c, fasting lipid profile, and urine for microalbuminuria were
analyzed. Severity of CAD was assessed by syntax score. Pearson
coefficient of correlation was used to analyze correlation between
the variables. P value of <0.05 will be taken as significant.
Results: BMI, hypertension and smokingwere not correlating with
severity of coronary artery disease. Biochemical parameters like
FBS, urine for microalbuminuria were not correlating with
severity of coronary artery disease but TC/HDL-C ratio was
significantly correlating with severity of coronary artery dis-
ease.(p¼0.04). In terms of duration of diabetes and severity of
coronary artery disease, It was not correlating but as compared to
non-diabetics, diabetics had higher syntax score (p < 0.001) and
more numbers of TVD (Triple Vessel Disease,(p < 0.001). Diabetics
had more numbers of total occlusion of vessel (p ¼ 0.02), Calcifi-
cation (0.003), Proximal vessel involvement (p < 0.001), CTO
(chronic total occlusion, (p ¼ 0.02) and Diffusely disease vessels (p
< 0.001), as compared to non-diabetics.
Conclusion: In our study except TC/HDL ratio, none of the
parameter was statistically significantly associated with severity
of coronary artery disease in diabetic population. Duration of
diabetes was not correlating with severity of coronary artery dis-
ease. Diabetics had more numbers of TVD, Total occlusion of
vessel, CTO, proximal vessel involvement, calcification and
diffusely diseased vessel.
Factors associated with normal coronary arteries
in patients with type 2 Diabetes Mellitus for more
than 10 years of duration
M.P. Srinivasan, C. Mahabala, R.L. Kamath, M.N. Bhat, N.D. Pai,
R.U. Bhat, P.K. Kamath
Department of Internal Medicine and Cardiology, Kasturba Medical
College, Manipal University, Mangalore, Karnataka, India
Background: In spite of severe CAD generally associated with
diabetes mellitus, some patients remain free of CAD even after
many years of treatment for diabetes.Study of risk factors asso-
ciated with such favorable CAD profile will help in identifying
these low risk patients and also to control these factors in diabetic
patients.
Methods: A case-control study of 63 patients with type 2 diabetes
mellitus who were on treatment for more than 10 years duration
and undergoing a coronary angiogram for the evaluation of CAD at
a tertiary care hospital were recruited from January 2014 to June
2014. Presence and absence CAD was assessed by syntax score.
Clinical history, anthropometric parameters and biochemical
parameters were analyzed. IR was determined by Homeostasis
model assessment (HOMA-IR). Multiple logistic regression after
adjusting for age, sex and other conventional risk factors of CAD
for the absence of CAD.
Results: The difference in HOMA-IR (2.27 ± 0.60 VS 3.87 ± 1.64, p <
0.001) and urinemicroalbumin (15.57 ± 14.51 VS 78.72 ± 119.09, p¼
0.004) were stastically significant among those who had CAD
when compared to those who did not have CAD. The difference in
lipid profile, HbA1C, fasting blood sugar, BMI, Waist hip ratio,
waist and hip circumference were not significant. The adjusted
i n d i a n h e a r t j o u rn a l 6 6 ( 2 0 1 4 ) s 1es 1 4 3S4


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Correlation of duration of diabetes with severity of coronary artery disease in patients with type 2 Diabetes Mellitus

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