Objective: To improve the understanding of chest pain and angina pectoris in patients with diabetes mellitus (DM).
Methods: The clinical features and angina characteristics of 4873 patients undergoing coronary angiography (CAG) were recorded. The characteristics of angina pectoris of 1431 patients with coronary artery diseases (CAD) complicated by DM were analyzed. For detecting coronary artery disease, the sensitivity, specificity, positive predictive value, and negative predictive value were analyzed according to chest pain and coronary angiography.
Results: Of the 1431 CAD patients with DM 187 only presented non-cardiac chest pain, 492 presented atypical angina, and 752 presented typical angina. Of the CAD 2056 patients without DM 297 only presented non-cardiac chest pain, 735 presented atypical angina, and 1024 presented typical angina. In detecting coronary artery disease, no matter with what type of chest pain, the positive predictive values of the DM group were all remarkably higher than those of the non-DM group, and the negative predictive values of the DM group were all remarkably lower than those of the non-DM group, however, there were not significant differences in the sensitivity and specificity between the DM group and non-DM group. In the non-DM group the number of stenotic branches of coronary artery was closely associated with the angina characteristics (P < 0.01), however, in the DM group the number of stenotic branches of coronary artery was not associated with the angina characteristics (P = 0.333).
Conclusion: Typical angina pectoris is a clinical manifestation with high accuracy in diagnosis of CAD. In the non-DM patients, the characteristics of chest pain reflect the severity of coronary artery stenosis.