Article Text

  1. A. J. Weissman1,
  2. S. Brown1,
  3. D. Hersh1,
  4. M. Rybstein1,
  5. G. Panagopoulos1,
  6. N. L. Coplan1
  1. 1Lenox Hill Hospital, New York, NY.


Introduction Diabetets mellitus (DM) is considered a coronary risk equivalent, although the independent significance of the metabolic syndrome is controversial. The purpose of this study was to determine whether gender affects the relationship of DM and CAD and the relationship between DM and the metabolic syndrome.

Methods This study included 469 patients with no known history of CAD who presented for elective cardiac catheterization, including 277 men (mean age 60 ± 11 years) and 192 women (mean age 63 ± 10 years). Patients were evaluated for presence (M+) or absence (M−) of metabolic syndrome using the NCEP-ATP III criteria. DM was defined as FBS ≥ 126 or DM Rx; CAD was defined as the presence of at least 70% stenosis in one of the three major coronary vessels or one of their significant branches, or 50% stenosis in the left main coronary artery. Relationships were assessed by using the Pearson chi-square test.

Results Metabolic syndrome was present in 233 of 468 patients and was found in a significantly higher percentage of women (118/191 women vs 114/277 men, p < .01). DM was present in 79 of 277 men and 49 of 191 women (p = NS).

DM+ was associated with a significantly higher incidence of CAD in both men and women. Comparing gender groups, DM+ men had a similar %CAD as DM+ women (62% vs 45%, p = NS). There was a trend toward DM+ women being more likely to have M+ than DM+ men (90% vs 75%, p = .06). DM− women were significantly more likely to have M+ than DM− men (52% vs 28%, p < .001), although DM− men had a significantly greater %CAD (42% vs 18%, p < .01).

Conclusion DM is a risk factor for obstructive coronary artery disease in both men and women. Despite a higher incidence of M+, DM− women have a significantly lower %CAD than DM− men.

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