QJM Advance Access published online on August 9, 2007
QJM, doi:10.1093/qjmed/hcm066
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Diabetes, but not the metabolic syndrome, predicts the severity and extent of coronary artery disease in women
From the 1Metabolic Unit, 2Institute of Cardiology and 4Department of Medicine, Kaplan Medical Center, Rehovot, and the Hebrew University Hadassah Medical School, Jerusalem, and 3Department of Statistics, Haifa University, Haifa, Israel
Address correspondence to Professor A. Schattner, Head, Department of Medicine, Kaplan Medical Center, Rehovot 76100, Hebrew University Hadassah Medical School, Jerusalem, Israel. email: amiMD{at}clalit.org.il
Received 27 April 2007 and in revised form 5 June 2007
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Abstract |
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Background: Previous studies have suggested that diabetes and metabolic syndrome are significant risk factors for coronary artery disease (CAD). However, in women, their relative importance remains controversial.
Aim: To evaluate risk factors for CAD in women and their association with the severity and extent of coronary angiographic findings.
Methods: We clinically evaluated 243 consecutive female patients with chest pain who underwent coronary angiography. The location and extent of coronary artery occlusions were assessed using the modified Gensini index.
Results: Compared with women with normal coronary arteries (n = 90), those with CAD (n = 153) reported less physical activity (p = 0.001), and had higher prevalences of diabetes (p = 0.046), hypertension (p = 0.002), and the metabolic syndrome (p = 0.001). They also had lower HDL cholesterol levels (p = 0.017), higher levels of triglycerides (p = 0.005), and higher fasting plasma glucose (FPG) (p < 0.001). Physical activity, FPG, serum triglycerides and HDL-cholesterol, but not the metabolic syndrome, were independent predictors of CAD. A score combining the extent and severity of angiographic findings was significantly higher in women with diabetes (p = 0.007), hypertension (p = 0.010) and FPG 
100 mg/dl (p = 0.031), but showed no association with the metabolic syndrome. In a multivariate linear regression analysis, diabetes was an independent predictor of the extent and severity of angiographic score (p = 0.013).
Discussion: Diabetes, fasting plasma glucose and hypertension, but not the metabolic syndrome, were associated with severity of coronary angiographic findings in these women.