Abstract
Introduction: Diabetes is a major challenge India is facing today. Cause of death in diabetes in the globe points towards cardiovascular diseases as commonest. However, infection is also a major contributor to mortality in diabetics in India as some of the previous Indian studies suggest.
Objective: To find out the mortality pattern in coronary artery disease (CAD) in diabetics visa vis those without diabetes in a tertiary care centre in Eastern India.
Methods: It is a retrospective study, in which data of in hospital death with CAD in 5 years (2014-2017) were collected from our Hospital Records Department. These data were tabulated with respect to age groups and co-morbidities.
Results: A total number of 284 patients died with CAD. Among them 188 were with diabetes and 96 were without diabetes. It is statistically significant with P= 0.03.Whereas male death (193) was predominate over female (91), with ratio 2:1. It is statistically significant with P= 0.02. The death due the CAD with respect to duration of its diagnosis in those with diabetes was compared to those without diabetes were also significant with P=0.01. The co-existence of infection/sepsis was also compared but it was not statistically significant.
Conclusion: In this study it is found that co-morbidity of diabetes is a major deciding factor in final outcome (death) of CAD. The death in males with CAD was higher than the age matched females. It may be due to relative protection against CAD in females of menstruating age.
Keywords: Diabetes mellitus; CAD; Morbidity; Mortality; Retrospective.
References
- Elhadd TA, Al-Amoudi AA, Alzahrani AS. Epidemiology, clinical and complications profile of diabetes in Saudi Arabia: a review. Ann Saudi Med 2007; 27(4): 241e250.
- Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014; 103(2): 137e149.
- Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011; 94(3): 311e321.
- Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al- Harthi SS, Arafah MR, Khalil MZ, et al. Diabetes mellitus in Saudi Arabia. Saudi Med J 2004; 25(11): 1603e1610.
- Al-Nozha MM, Arafah MR, Al-Mazrou YY, Al- Maatouq MA, Khan NB, Khalil MZ, et al. Coronary artery disease in Saudi Arabia. Saudi Med J 2004; 25(9): 1165e1171.
- Al-Nozha MM, Abdullah M, Arafah MR, Khalil MZ, Khan NB, Al-Mazrou YY, et al. Hypertension in Saudi Arabia. Saudi Med J 2007; 28(1): 77e84.
- Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study. Diabetes Care 1979;2:120–6.
- Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham Study. JAMA 1979;241:2035–8.
- Gupta AK, Bharadwaj A, Ashotra S, et al. Feasibility and training of multipurpose workers in detection, prevention and control of coronary artery disease in apple-belt of Shimla hills. South Asian J Prev Cardiol. 2002;6:17e22.
- Joshi R, Cardona M, Iyengar S, et al. Chronic disease s now a leading cause of death in rural India: mortality data from the Andhra Pradesh Rural Health Initiative. Int J Epidemiol. 2006;35: 1522e1529.
- Ezzati M, Lopez AD, Rodgers A, et al. Comparative Quantification of Health Risks. Global and Regional Burden of Disease Attributable to Major Risk Factors. Geneva: World Health Organisation; 2004.
- Enas EA, Yusuf S, Mehta J. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol. 1992;70:945e949.
- Yusuf S, Hawken S, Ounpuu S, et alThe INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case control study. Lancet. 2004;364:937e952.
- O’Donnell MJ, Xavier D, Liu Lisheng, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a caseecontrol study. Lancet. 2010;376: 112e123.
- Bhatnagar D, Anand IS, Durrington PN, et al. Coronary risk factors in people from the Indian subcontinent living in west London and their siblings in India. Lancet. 1995;345:405e409.
- King H, Aubert RE, Herman WH. Global burden of diabetes, 1995e2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21: 1414e1431.
- Ramachandran A. Epidemiology of diabetes in Indiadthree decades of research. J Assoc Physicians India. 2005;53:34e38.
- Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the challenge of chronic diseases in India. Lancet. 2005;366:1744e1749.
- Beaglehole R, Yach D. Globalization and the prevention and control of non-communicable diseases: the neglected chronic diseases of adults. Lancet. 2003;362:903e908.
- Emberson JR, Whincup PH, Morris RW, Walker M. Social class differences in coronary heart disease in middle-aged British men: implications for prevention. Int J Epidemiol. 2004;33:289e296.
- Singh RB, Sharma JP, Rastogi V, et al. Prevalence of coronary artery disease and coronary risk factors in rural and urban populations of north India. Eur Heart J. 1997;18:1728e1735.
- Gupta R, Gupta VP, Sarna M, et al. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart J. 2002;54:23e30.
- Thankappan KR, Shah B, Mathur P, et al. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res. 2010;131:53e63.
- Ng N, Stenlund H, Bonita R, Hakimi M, Wall S, Weinehall L. Preventable risk factors for noncommunicable diseases in rural Indonesia: prevalence study using WHO STEPS approach. Bull World Health Organ. 2006;84:305e313.
- Hoang VM, Byass P, Dao LH, Nguyen TK, Wall S. Risk factors for chronic disease among rural Vietnamese adults and the association of these factors with sociodemographic variables: findings from the WHO STEPS survey in rural Vietnam, 2005. Prev Chronic Dis. 2007;4:A22.
- Ong KL, Cheung BM, Man B, Lau CP, Lam KSL. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999e2004. Hypertension. 2007;49:69e75.
- Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999e2002. Diabetes Care. 2006;29:1263e1268.
- Prevalence and extent of dyslipidemia and recommended lipid levels in US adults with and without cardiovascular comorbidities: the National Health and Nutrition Examination Survey 2003e2004. Am Heart J. 2008;156:112e119.
- The Cardiological Society of India Kerala Chapter. Coronary Artery Disease and its Risk Factors Prevalence Study (CSI Kerala CRP Study). 2011 unpublished data.
Corresponding Author
Dr Siba Prasad Dalai
Assistant Professor, Department of Medicine, IMS and SUM Hospital, Bhubaneswar, Odisha, India
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.131
