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


OBJECTIVE
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 >or=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).


CONCLUSIONS
Diabetes, fasting plasma glucose and hypertension, but not the metabolic syndrome, were associated with severity of coronary angiographic findings in these women.
Zornitzki
T
T
Metabolic Unit, Kaplan Medical Center, Rehovot, Hebrew University Hadassah Medical School, Jerusalem, Israel.
Ayzenberg
O
O
Gandelman
G
G
Vered
S
S
Yaskil
E
E
Faraggi
D
D
Caspi
A
A
Goland
S
S
Shvez
O
O
Schattner
A
A
Knobler
H
H
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood*; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides