Angina in Coronary Artery Disease Patients With and Without Diabetes: US National Health and Nutrition Examination Survey 2001-2010

Background: Angina pectoris (AP) is common in coronary artery disease (CAD), but whether those with diabetes mellitus (DM) experience AP as often as those without DM is unclear. Hypothesis: AP prevalence is similar in those with vs without DM in a community sample with CAD. Methods: In adults with CAD in the US NHANES 2001-2010, AP was determined by self-report and Rose questionnaire and compared by DM status. Physical functioning and medication use were also evaluated. Results: Of 1957 adults with CAD, 619 (28.2%) had DM. Prevalence of AP was similar in those with vs without DM (48.9% vs 46.3%; P=0.38). There was a trend toward more severe AP in those with glycated hemoglobin >= 7% (50.4%) vs <7% (27.1%; P= 0.09). Adjusted logistic regression showed a similar odds of AP (1.06, 95% CI: 0.84-1.33) in those with vs without DM, although among DM, a 2-fold greater odds of AP in women vs men. Physical functioning was worse in those with vs without AP overall (score of 25.9 vs 24.3; P< 0.001) and further diminished within those with comorbid DM (26.7 vs 24.0; P< 0.001). Among those with AP, those with vs without DM were more likely on beta-blockers, statins, angiotensin-converting enzyme inhibitors, and antiplatelet therapy. Conclusions: AP in CAD patients is similar among those with vs without DM, despite greater use of evidence-based therapies in DM patients. Greater physical limitations exist in those with vs without AP, and further diminish with comorbid DM.