Multi-vessel Coronary Artery Disease in Diabetic Patients Presenting with Anterior Wall Myocardial Infraction

Abstract

Objectives: This study aimed to determine the frequency of multi-vessel coronary artery disease (MVD) in diabetic patients presenting with anterior wall myocardial infarction (AWMI).

Methodology: In this descriptive cross-sectional study, we included diabetic patients with AWMI aged between 30-70 years. Patients with either a history of clinical diagnosis based on HbA1c >6.5% / fasting blood sugar > 126 mg/dL/ random blood sugar >200 mg/dL or taking anti-hyperglycemic treatment for at least six months were taken as diabetics. Patients with angiographic evidence of significant (>70%) stenosis in two major epicardial vessels were categorized for MVD.

Results: A total of 196 diabetic patients with anterior wall MI were included. Of which the mean age was 57.6±12.3 years, and 128 (65.3%) were male patients. MVD was observed in 91 (46.4%) patients. The MVD was found to be associated with a BMI ≥ 24 kg/m² with a frequency of 51.5% vs. 35%; p=0.033, as compared to a BMI < 24 kg/m². The frequency of MVD was higher among middle-class patients, with a frequency of 36.2%, 58.3%, and 39.5% (p=0.014) for patients in the low, middle, and upper classes, respectively. Similarly, the MVD frequency was higher among patients with hypertension (60.6% vs. 28.7%) and hyperlipidemia (62.1% vs. 38.5%) compared to non-hypertensive and non-hyperlipidemia, respectively.

Conclusion: It is to be concluded that MVD is highly prevalent in diabetic patients presenting with AWMI, and it was found to be associated with BMI ≥ 24 kg/m², middle class, hypertension, and hyperlipidemia.