Diabetes, but not the metabolic syndrome, predicts the severity and extent of coronary artery disease in women

• Published in: QJM : An International Journal of Medicine Vol. 100; no. 9; pp. 575 - 581
• Main Authors: Zornitzki, T., Ayzenberg, O., Gandelman, G., Vered, S., Yaskil, E., Faraggi, D., Caspi, A., Goland, S., Shvez, O., Schattner, A., Knobler, H.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-09-2007; Oxford Publishing Limited (England)
• Subjects: Aged; Biological and medical sciences; Blood Glucose - analysis; Cholesterol, HDL - blood; Coronary Angiography; Coronary Artery Disease - blood; Coronary Artery Disease - diagnosis; Coronary Artery Disease - etiology; Diabetes Mellitus - blood; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; General aspects; Humans; Hypertension - blood; Medical sciences; Metabolic Syndrome - blood; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Severity of Illness Index; Triglycerides - blood; Endocrinopathy; Human; Diabetes mellitus; Prediction; Cardiovascular disease; Metabolic diseases; Severity; Coronary heart disease; Medicine; X Syndrome; Adult; Female; Predictive factor; Woman
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hcm066

Background: Previous studies have suggested that diabetes and metabolic syndrome are significant risk factors for coronary artery disease (CAD). However, in women, their relative importance remains controversial. Aim: To evaluate risk factors for CAD in women and their association with the severity and extent of coronary angiographic findings. Methods: We clinically evaluated 243 consecutive female patients with chest pain who underwent coronary angiography. The location and extent of coronary artery occlusions were assessed using the modified Gensini index. Results: Compared with women with normal coronary arteries (n = 90), those with CAD (n = 153) reported less physical activity (p = 0.001), and had higher prevalences of diabetes (p = 0.046), hypertension (p = 0.002), and the metabolic syndrome (p = 0.001). They also had lower HDL cholesterol levels (p = 0.017), higher levels of triglycerides (p = 0.005), and higher fasting plasma glucose (FPG) (p < 0.001). Physical activity, FPG, serum triglycerides and HDL-cholesterol, but not the metabolic syndrome, were independent predictors of CAD. A score combining the extent and severity of angiographic findings was significantly higher in women with diabetes (p = 0.007), hypertension (p = 0.010) and FPG ⩾100 mg/dl (p = 0.031), but showed no association with the metabolic syndrome. In a multivariate linear regression analysis, diabetes was an independent predictor of the extent and severity of angiographic score (p = 0.013). Discussion: Diabetes, fasting plasma glucose and hypertension, but not the metabolic syndrome, were associated with severity of coronary angiographic findings in these women.