A Comparative Study of Clinical and Angiographic Profile of Acute Coronary Syndrome in Young Diabetics and Non-diabetics

Abstract

Introduction: The clinical presentations and angiographic findings of Coronary Artery Disease (CAD) vary from diabetic and non-diabetic patients and also vary with the age of patients. CAD in patients below the age of 45 is a special subset. Clinical presentations of CAD in young patients with various risk factors differ, which may play an important role in management strategies. Aim: To compare the clinical and angiographic profile in patients presenting as Acute Coronary Syndrome (ACS) with Diabetes Mellitus (DM) and without DM below the age of 45 years. Materials and Methods: It was a comparative observational study done between the time period of January 2018 to June 2019. in patients presenting with symptoms suggestive of ACS. Patients below 45 years of age were subdivided into two major groups, Group A (ACS with DM) and Group B (ACS without DM) and analysed for the clinical and angiographic pattern. The data was analysed using SPSS software. Significance was assessed with Chi-square test. Results: Eighty ACS patients were analysed. Mean age was found to be 41.2±4.01 years, with a mean Glycated Haemoglobin (HbA1c) value of 8.65±3.3%. Clinical profile and pattern of involvement of coronary arteries, as assessed by coronary angiography were found to be different in younger CAD patients; ST-Elevation Myocardial Infarction (STEMI) was the most common type of ACS. Single Vessel Disease (SVD) was the most common angiographic finding and Echocardiography (ECHO) showed normal Left Ventricular (LV) function. Atypical chest pain and multiple vessel disease were common in diabetics with higher HbA1c (p=0.001). Conclusion: Younger and non-diabetic ACS patients get lesser burden of disease as compared with diabetics and elderly people. This finding might help in prognostication of disease.

Keywords

• coronary imaging
• glycaemic control
• ischemic heart disease
• nonelderly
• prognosis