Comparison of diabetic and non-diabetic patients referred for coronary angiography

Aim: To evaluate whether diabetic patients differ from non-diabetic patient s when referred for coronary angiography regarding previous history, indica tion for and findings at coronary angiography, use of medication, exercise test results and mortality. Methods: Data were prospectively collected on p atients referred for consideration of coronary revascularization to seven o f the eight public Swedish heart centers that performed approximately 92% o f all bypass operations in Sweden in 1994. Results: 2762 patients were incl uded of whom 406 (15%) had a history of diabetes mellitus. There was no dif ference in age or sex in the two groups. Chronic stable angina was the most common indication (73% in both groups) and only 3% were admitted due to si lent ischemia. Diabetic patients had more severe symptoms (Canadian Cardiov ascular Society III-IV) than non-diabetic patients (66% vs. 58%, p<0.01). T hey more frequently used ACE-inhibitors (33% vs. 19%, p<0.0001) and calcium channel blockers (47% vs. 40%, p<0.01) and more often had a diagnosis of a rterial hypertension than non-diabetic patients (50% vs. 33%, p<0.0001). Di abetic patients more often had depressed myocardial function (EF<35%); 12% and 8%, respectively (p<0.01), and more extensive coronary artery disease ( left main/3-VD; 48% vs. 37%, p<0.001). The mortality during the subsequent 21 months was 7.9% among diabetic patients and 3.6% among non-diabetic pati ents (p<0.001). Conclusion: Among patients being referred for coronary angi ography in Sweden, 15% were patients with a history of diabetes. They diffe red from patients without such a history by more often having severe sympto ms and a higher prevalence of left main/triple vessel disease. Coronary ang iography may thus be underused in diabetic patients with chest pain. (C) 19 99 Elsevier Science Ireland Ltd. All rights reserved.