Correlation between prediabetes and coronary artery disease severity in patients undergoing elective coronary angiography

Abstract

Background: Diabetes is a chronic disease that is responsible for a high rate of morbidity and mortality which can be attributed to atherosclerosis and cardiovascular disease. Diabetes is heralded by prediabetes which not only indicates a higher risk of developing diabetes but also increases the burden of cardiovascular disease. The objective was to observe the effect of prediabetes on the severity of coronary artery disease in patients undergoing elective coronary angiography. Seven hundred and thirty-one patients were admitted for elective coronary angiography and/or PCI starting from September 2017 to August 2018. Patients were divided into group A (normoglycemic group, N = 228), group B (prediabetes group, N = 177), and group C (diabetic group, N = 326). Coronary artery disease (CAD) severity including number of vessels affected and atherosclerotic burden by Gensini score were compared among different groups. Results: The number of vessels affected as well as left main (LM) disease was higher in the prediabetes group when compared to the normoglycemic group (P,=0.001, P = 0.009, respectively) and was comparable to the diabetes group (P = 0.4, P = 0.6, respectively). Prediabetes showed a Gensini score higher than the normoglycemic group (P = 0.0001) with no significant difference when compared to the diabetic group (P = 0.9). Conclusion: Prediabetes is associated with high atherosclerotic burden and coronary artery disease complexity that is similar to diabetic than normoglycemic individuals.

Severity of Coronary Artery Disease in Prediabetic Patients Undergoing Elective Coronary Angiography

“…We assessed the incidence of atherosclerosis CAD and its burden in prediabetes and its impact on coronary vessels and CAG outcomes. In our study, 110 (24.01%) patients had prediabetes; the prevalence of men was high in all groups, while in other studies, women were predominant in the diabetes group [10,11]. The frequency of prediabetes with smoking and CAG + PCI/PTCA is higher in the prediabetes group, similar to the other studies conducted by Muhammed et al [10].…”

“…In our study, 110 (24.01%) patients had prediabetes; the prevalence of men was high in all groups, while in other studies, women were predominant in the diabetes group [10,11]. The frequency of prediabetes with smoking and CAG + PCI/PTCA is higher in the prediabetes group, similar to the other studies conducted by Muhammed et al [10]. Our study results found no statistical significance in smoking among the groups.…”

“…Dong et al enrolled 409 patients suspected of having a myocardial infarction undergoing CAG; they found that the severity of CHD and coronary stenosis increased with elevated HbA1c levels [17]. Another study by Muhammed et al reported that prediabetic patients have similar CAD pattern and severity as that of diabetic patients, and have severe CAD severity and left main stem disease as compared to euglycemic patients [10]. These results are similar with our results as we also found a higher burden of triple valve disease, and double vessel disease in prediabetic and diabetic patients ([28.18%, 19.09%], [32.68%, 20.98%], versus [20.28%, 12.59%] in euglycemic patients, respectively [P = .01]).…”

Intermediate Hyperglycemia Increases the Risk of All-Cause Mortality in Premature Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention

“…Patients with intermediate hyperglycemia of HbA1c ranging from 6.0 to 6.5% were defined as prediabetic according to the World Health Organization (WHO) [ 8 ]. Compared with normoglycemic individuals, prediabetes is related to a high atherosclerotic burden and the number of vessels affected in Ahmed’s study [ 9 ]. Another study illustrated that patients with prediabetes have a significantly increased long-term risk of cardiovascular disease after PCI [ 10 ].…”

Observation on clinical effect of Huoxue-Jiangtang decoction formula granules in treating prediabetes: a randomized prospective placebo-controlled double-blind trial protocol

“…When the prediabetic patients do not receive timely diagnosis and treatment, about 5-10% of them will rapidly progress to the stage of diabetes, and the rest will gradually develop diabetes over the next 5 years. In the meantime, the incidence and severity of diseases such as coronary artery disease, heart failure, hypertension and retinopathy in patients with prediabetes are aggravated with more obvious blood glucose fluctuation, thus seriously affecting their quality of life [3][4][5][6]. As a result, timely diagnosis and intervention for diabetics can postpone the progression of prediabetes to diabetes and lower the risk of related complications, which is critical for both society and patients.…”