title: Manipal diabetes coronary artery severity score.
abstract: OBJECTIVE
  To develop a risk score, for identifying severe and complex CAD in patients with type 2 diabetes mellitus.
  
  
  METHODS
  In this cross sectional study, 179 patients with type 2 diabetes mellitus undergoing coronary angiogram for the evaluation of suspected coronary artery disease (CAD) were recruited at a tertiary-care hospital. Patients were divided into developmental (n=124) and validation (n=55) cohorts. Biochemical and anthropometric parameters were analysed. Predictors of severe and complex CAD (SYNTAX Score>22) were identified by multiple logistic regression analysis.
  
  
  RESULTS
  Insulin resistance>3.4 (OR: 21.26, 95% CI: 5.71-79.09), duration of diabetes>5years (OR: 13.50, 95% CI: 3.13-58.25), total cholesterol/HDL-C ratio>5 (OR: 2.75, 95% CI: 0.66-11.55) and waist circumference>96cm (OR: 5.08, 95% CI: 1.27-20.42) were independent predictors of severe and complex CAD, and Manipal Diabetes Coronary Artery Severity Score was developed.
  
  
  CONCLUSIONS
  The prediction of severe and complex CAD was achieved with this simple score, and thus enabling effective identification of patients beforehand, who are not likely to be suitable for angioplasty.
authors: Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Mukund P
authors: MP
authors: Srinivasan
authors: Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Padmanabh K
authors: PK
authors: Kamath
authors: Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Narayan M
authors: NM
authors: Bhat
authors: Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Narasimha D
authors: ND
authors: Pai
authors: Department of Cardiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Rajesh U
authors: RU
authors: Bhat
authors: Department of Biochemistry, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors: Poornima A
authors: PA
authors: Manjrekar
authors: Department of Internal Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India. Electronic address: chakrapani2009@hotmail.com.
authors: Chakrapani
authors: C
authors: Mahabala
mesh_terms: D000368:Aged; D000886:Anthropometry; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Coronary artery disease; Insulin resistance; SYNTAX score; Type 2 diabetes mellitus