CAROTID DISEASE IN DIABETIC PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING

Muhammad Shahid, Abdul Rehman Abid, Muhammad Ashraf Dar, Ahmad Noeman, Shahid Amin, Muhammad Azhar

Abstract


Objective: To compare the severity of carotid artery disease in diabetic and non-diabetic patients
undergoing coronary artery bypass grafting. Methods: From January to June 2008, 379 patients
undergoing elective coronary artery bypass surgery were preoperatively evaluated for the presence of
carotid stenoses by duplex scanning. Patients were divided into two groups, Group I, 156 (41.2%)
diabetic patients and Group II, 223 (58.8%) non-diabetic patients. Results: There were 314 (82.8%)
males and 65 (17.2%) females with a mean age of 57.2±9.1 years. In diabetic group there were 125
(80.1%) males and 31 (19.9%) females with a mean age of 56.3±8.9 years. Left main stem stenosis was
present in 59 (37.8%) diabetics and 45 (20.2%) non-diabetics (p<0.0001). Diffuse disease in left
anterior descending (LAD) artery was observed in more diabetic patients 72 (46.2%) as compared to
non-diabetics 83 (37.2%) (p<0.295). Single tight stenosis in LAD was observed in more non-diabetics.
Significant carotid artery stenosis was observed in 50 (13.2%) patients. Carotid artery stenosis was
observed in 30 (19.2%) diabetics as compared to 20 (9%) non-diabetics (p<0.004). Analysis of
percentage stenosis of carotid artery disease in the study population revealed that >70% stenosis was
present in 20 (5.3%) with 13 (8.3%) diabetics and 7 (3.1%) non-diabetics (p<0.025). Stenosis of 50–
70% was observed in 30 (7.9%) of which 17 (10.9%) were diabetics and 13 (5.8%) were non-diabetics.
Conclusion: Presence of diabetes mellitus is associated with diffuse coronary artery disease and
significant carotid artery disease in patients undergoing coronary artery bypass grafting.
Keywords: Atherosclerosis, Coronary artery disease, Carotid artery disease, Coronary artery
bypass grafting, Diabetes Mellitus

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