DIABETIC RETINOPATHY AS A PREDICTOR OF SEVERITY OF CORONARY ARTERY DISEASE

OBJECTIVES: To determine the association between diabetic retinopathy (DR) and severity of coronary artery disease (CAD) and evaluate the relation of stage of DR with severity of CAD. METHODS: This cross-sectional study was conducted in Cardiology Unit, Lady Reading Hospital, Peshawar from January-June, 2017. Patients with diabetes mellitus for >5years who underwent coronary angiography (CA) were included. All patients underwent fundoscopy and categorized into: No-DR, pre-proliferative-DR and proliferative-DR. CA was performed to assess the severity of CAD and patients were categorized into: none, mild, moderate and severe CAD on the basis of number of vessels involved or left main stem (LMS) disease. The correlation between DR and CAD was determined by chi-square test and prevalence odd ratios (POR) were calculated by using logistic regression model. RESULTS: A total of 166 patients with mean age of 55.5±8.8years were included in the study, of which 79 were males, 35 had no-DR, 110 had pre-proliferative-DR and 21 had proliferative-DR while 63 patients had mild CAD, 50 had moderate CAD and 18 had severe CAD. By using Chi square test, association between DR and severity of CAD was calculated to be 86.68 (p-0.000). After adjustments for various risk factors, PORs for severity of CAD with increasing stage of DR were found to be significantly increased from 0.27 times for no-DR to 4.27 times for pre-proliferative-DR and 6.33 times for proliferative-DR. CONCLUSION: DR is not only strongly associated with CAD but higher stage of retinopathy predicts a more severe CAD increasing the odds of CAD by 2.27 times