Nauman Naseer, Zeeshan Ghous, Muhammad Hussain, Waqar Ahmed.
Correlation of angiographic severity of the disease and different groups of oral anti-diabetic drugs (Metformin VS Metformin plus other anti-diabetic drugs VS other Diabetic drugs only) in patients with type II Diabetes Mellitus.
J Cardiovascular Dis Jan ;14(1):5-10.

BACKGROUND: Diabetes mellitus is a very important risk factor for coronary artery disease as it accelerates atherosclerosis, endothelial dysfunction and ultimately myocardial infarction or acute coronary syndrome. Different antidiabetic medications are available for the glycemic control in patients with type II diabetes mellitus.It is not clear which medication is better in terms of its effects on decreasing the angiographic severity. Metformin is the preferred choice for initiating treatment for Diabetes.The United Kingdom Prospective Diabetes Study (UKPDS) demonstrated that in obese type 2 diabetic patients metformin reduces the risk of MI more than sulfonylureas or insulin. The vasoprotective role of metformin is largely independent of its hypoglycemic action and has been ascribed to pleiotropic effects. METHODOLOGY:A total of 163 patients were enrolled in the study. Patients were divided into three major groups. The first group included those patients (total 33 patients) who were taking metformin only, the second group included those patients (41 patients ) who were taking metformin with other diabetic medication (sulfonylurea, thiazolidinedione or insulin) while third group included those patients (89 patients) who were taking other diabetic medication (sulfonylurea, thiazolidinedione or insulin) without metformin. The SPSS version 20 was used to evaluate the data. RESULTS:Out of total 163 patients, the first group which included 33 patients who were taking only metformin there were 7 (21.2%) patients who had left main disease, 19 (57.57%) patients who had LAD disease, 14 (42.42%) patients with LCX disease and 13 (39.4%) patients who had disease in RCA. While in the second group the number and percentage of patients with left main, LAD, LCX and RCA disease 1 patients (2.4%), 28(68.29%) patients, 23 (56.09%) patients and 20 (48.8%) patients respectively while in the third group they were 4 patients (4.5%), 54 (60.67%) patients, 45 (50.56%) patients and 34 (38.2%) patients respectively. CONCLUSION:Based on the retrospective analysis with limitations as noted, there is no statistical difference for obstructive coronary artery disease among different diabetic treatment groups in our study (Metformin Vs Metformin plus other Diabetes drugs Vs other Diabetes drugs only),apart from left main stem disease patients.

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