Sex-Dependent Effects of Diabetes Mellitus on the Revascularization Rate in Mid-Term Follow up of Young Patients With Coronary Artery Disease Publisher Pubmed



Lotfitokaldany M¹ ; Abbasi SH¹ ; Karimi A¹ ; Kassaian SE¹ ; Davarpasand T¹ ; Jalali A¹ ; Sadeghian S¹ Show Affiliations
Source: Journal of Diabetes and its Complications Published:2017

Abstract

Aims We investigated the association between Type-2 diabetes mellitus (DM) and the need for revascularization at a 5-year follow-up of young coronary artery disease patients and the role of sex in this regard. Methods Among 1121 young (males ≤ 45, and females ≤ 55 years) patients (female: 49.7%) from Tehran Heart Center's Premature Coronary Atherosclerosis Cohort, 371(33.1%) had diabetes prior to angiography. Revascularization was considered as either percutaneous coronary intervention or coronary artery bypass graft surgery. Results The mean follow-up duration was 57.67 ± 22.43 months. In the univariable analysis, diabetics were at a significantly higher risk of revascularization than nondiabetics (Sub-distributional Hazard Ratio [SHR] = 1.843, P value < 0.001). There was no association between DM and revascularization among men (SHR = 1.232, P value = 0.508). In contrast, women with DM had threefold more revascularization risk than women without DM (SHR = 3.519, P value < 0.001). After adjustment for confounding factors, the risk of revascularization in diabetics compared to nondiabetics increased to 2.139 fold (95% CI = 1.473, 3.108) among the whole subjects, remained nonsignificant among men, and increased significantly to 3.725 fold (95% CI = 2.067, 6.725) in women. Conclusions Our data showed that in women with premature CAD, but not in men, DM may have a significant role in emerging revascularization during a mean follow-up of 5 years. © 2017