Comparison of Severity of Coronary Artery Disease in Diabetic and Non- Diabetic Subjects using Gensini Score in Indian Subjects

Abstract

Background: Diabetes mellitus is usually associated with higher risk of microvascular and macrovascular complication especially Coronary Artery Disease (CAD). The Study was aimed to study the severity of CAD in diabetic and nondiabetic population who has undergone coronary angiography using Gensini scoring. Methodology: 233 subjects admitted for coronary angiography were studied. All subjects were subjected to full medical history and physical examination; echocardiography, measurement of glycated hemoglobin (HbA1c), detection of urine microalbumin and coronary angiography was carried on. Severity of CAD was assessed by using Gensini score. Results: Out of 233 subjects, 140 were diabetics (60.1%). Among diabetics 95% had abnormal Gensini score, which is statistically significant (p=0.004<0.01), among nondiabetic subjects 84% had abnormal Gensini score (suggests CAD), with odd’s ratio 3.6 (CI 1.4 to 9.3). There was good correlation between diabetes duration and Gensini score with r=0.626 (p=0.0001). Mean age in diabetics is 60years and in nondiabetics is 58 years. Multiple regression analysis of diabetes duration, smoke pack years, hypertension, Ankle Brachial Index (ABI), Left Ventricular ejection fraction, glycated hemoglobin, Total Cholesterol/High density cholesterol (TC/HDL), Non-HDL cholesterol, urine microalbumin, BMI (Body Mass Index) and Waist Hip ratio with Gensini score; showed significant positive impact on Gensini score by Diabetes duration (beta=0.455), Urine microalbumin (beta=0.207), TC/HDL (beta=0.173) and significant negative impact on Gensini score by ABI (beta=-0.388), LVEF (beta= 0.102). Conclusion: Severity of CAD as assessed by Gensini Score was higher in subjects with diabetes when compared to nondiabetic Indian subjects.