Diabetes, but not the metabolic syndrome, predicts the severity and extent of coronary artery disease in women

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.