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


Objective: To compare the severity of carotid artery disease in diabetic and non-diabetic patientsundergoing coronary artery bypass grafting. Methods: From January to June 2008, 379 patientsundergoing elective coronary artery bypass surgery were preoperatively evaluated for the presence ofcarotid 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 waspresent in 59 (37.8%) diabetics and 45 (20.2%) non-diabetics (p<0.0001). Diffuse disease in leftanterior descending (LAD) artery was observed in more diabetic patients 72 (46.2%) as compared tonon-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 wasobserved in 30 (19.2%) diabetics as compared to 20 (9%) non-diabetics (p<0.004). Analysis ofpercentage stenosis of carotid artery disease in the study population revealed that >70% stenosis waspresent 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 andsignificant carotid artery disease in patients undergoing coronary artery bypass grafting.Keywords: Atherosclerosis, Coronary artery disease, Carotid artery disease, Coronary arterybypass grafting, Diabetes Mellitus


Lüscher TF, Creager MA, Beckman JA, Cosentino F. Diabetes

and Vascular Disease: Pathophysiology, Clinical Consequences,

and Medical Therapy: Part II. Circulation 2003;108:1655–61.

Preis SR, Hwang S, Coady S, Pencina MJ, D’Agostino, Sr, RB,

Savage PJ. Trends in All-Cause and Cardiovascular Disease

Mortality Among Women and Men With and Without Diabetes

Mellitus in the Framingham Heart Study, 1950 to 2005.

Circulation 2009;119:1728–35.

Scognamiglio R, Negut C, Ramondo A, Tiengo A, Avogaro A.

Detection of Coronary Artery Disease in Asymptomatic

Patients With Type 2 Diabetes Mellitus. J Am Coll Cardiol


Beckman JA, Creager MA, Libby P. Diabetes and

atherosclerosis: epidemiology, pathophysiology, and

management. JAMA 2002;287:2570–81.

Lee CD, Folsom AR, Pankow JS, Brancati FL, Atherosclerosis

Risk in Communities (ARIC) Study Investigators.

Cardiovascular Events in Diabetic and Nondiabetic Adults With

or Without History of Myocardial Infarction. Circulation


Air EL, Kissela BM. Diabetes, the Metabolic Syndrome, and

Ischemic Stroke: Epidemiology and possible mechanisms.

Diabetes Care 2007;30:3131–40.

Komorovsky R, Desideri A, Coscarelli S. Impact of carotid

arterial narrowing on outcomes of patients with acute coronary

syndromes. Am J Cardiol 2004;93:1552–5.

Lombardo A, Biasucci LM, Lanza GA. Inflammation as a

possible link between coronary and carotid plaque instability.

Circulation 2004;109:3158–63.

Evangelopoulos N, Trenz MT, Beckman A. Simultaneous carotid

endarterectomy and coronary artery bypass grafting in 313

patients. Cardiovasc Surg 2000;8:31–40.

Aboyans V, Lacroix P, Guilloux J, Rollé F, Guyader AL, Cautrès

M, et al. A predictive model for screening cerebrovascular

disease in patient undergoing coronary artery bypass grafting.

Interact Cardiovasc Thorac Surg 2005;4:90–5.

Tarzamni MK, Afrasyabi A, Farhoodi M, Karimi F, Farhang S.

Low prevalence of significant carotid artery disease in Iranian

patients undergoing elective coronary artery bypass. Cardiovasc

Ultrasound 2007;5:3–8.

Paulose KP. Carotid artery disease in type 2 diabetes patients. Int

J Diab Dev Countries 2002;22:133–4.

Birincioglu L, Arda K, Bardakci H, Ozberk K, Bayazlt M,

Cumhur T, et al. Carotid Disease in Patients Scheduled for

Coronary Artery Bypass: Analysis of 678 Patients. Angiology


Tanimoto S, Ikari Y, Tanabe K, Yachi S, Nakajima H,

Nakayama T, et al. Prevalence of Carotid Artery Stenosis in

Patients With Coronary Artery Disease in Japanese Population.

Stroke 2005;36:2094–8.

Chen WH, Wah Ho DS, Ho SL, Cheung RT, Cheng SWK.

Prevalence of Extracranial Carotid and Vertebral Artery Disease

in Chinese Patients With Coronary Artery Disease. Stroke


Kallikazaros I, Tsioufis C, Sideris S, Stefanadis C, Toutouzas P.

Carotid Artery Disease as a Marker for the Presence of Severe

Coronary Artery Disease in Patients Evaluated for Chest Pain.

Stroke 1999;30:1002–7.

Zaidi NR, Khan NA, Dodhy K, Mahmood K. Carotid Duplex

imaging is better modality than Angiography to diagnose carotid

artery stenosis in patients for Endarterectomy Ann King Edward

Med Coll 2004;10:380–3.

Waheed A, Shahbaz A, Ghaffar A, Abid AR, Ahmed N, Khan

JS. Carotid Endarterectomy at Punjab Institute of Cardiology,

Lahore: mid term postoperative results. Ann King Edward Med

Coll 2005;11:437–41.

Mitsuhashi N, Onuma T, Kubo S, Takayanagi N, Honda M,

Kawamori R. Coronary Artery Disease and Carotid Artery

Intima-Media Thickness in Japanese Type 2 Diabetic Patients.

Diabetes Care 2002;25:1308–12.

Paraskevas KI, Mikhailidis DP, Liapis CD. Internal Carotid

Artery Occlusion: Association with Atherosclerotic Disease in

Other Arterial Beds and Vascular Risk Factors. Angiology


Komorovsky R, Desideri A. Carotid ultrasound assessment of

patients with coronary artery disease: a useful index for risk

stratification. Vascular Health and Risk Management



Most read articles by the same author(s)

1 2 > >>