Most Type 2 Diabetes, CAD Patients Present With Angina

History of β-blocker use, previous percutaneous coronary intervention tied to typical angina

WEDNESDAY, Jan. 4 (HealthDay News) -- A large proportion of patients with type 2 diabetes mellitus and documented stable coronary artery disease have symptoms of angina, and the nature of symptom presentation may be associated with the type of previous revascularization, according to a study published in the Jan. 1 issue of The American Journal of Cardiology.

Ashok Krishnaswami, M.D., of Kaiser-Permanente Medical Center San Jose, Calif., and colleagues assessed the symptoms of angina in 2,319 participants using baseline data from the multicenter Bypass Angioplasty Revascularization Investigation 2 Diabetes trial. To obtain entry into the trial, every patient had to have a coronary angiogram documenting one or more vessels with a ≥50 percent stenosis that was suitable for revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) with either objective documentation of ischemia or subjective documentation of angina with a ≥70 percent stenosis.

The researchers found that 82 percent of participants had symptoms of angina, while 18 percent did not. Symptom status for all participants could be divided approximately into typical angina (20 percent), anginal equivalents (20 percent), combination of typical angina and anginal equivalents (40 percent), and no angina or anginal equivalents (20 percent). A history of β-blocker use and previous PCI were associated with higher odds of typical angina.

"We believed the type of symptoms which patients present with may vary with whether they have undergone previous revascularization and also with the type of previous coronary revascularization (i.e., PCI or CABG)," write the authors.

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