Document Type : Original Article
Authors
1
Department of Acupuncture, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2
Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3
Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
ABSTRACT
Background: Background: Diabetes is a major risk factor for cardiovascular disease and is associated with increased morbidity and mortality. Controlling for confounding factors is essential when estimating its relationship with coronary artery disease. This study aimed to estimate the magnitude of the association between diabetes and coronary artery obstruction using propensity score–matched controls in a case-control study.
Methods: This case-control study was conducted on 903 patients admitted to Imam Reza Hospital in 2015, including 288 cases who underwent CABG due to coronary artery obstruction and 615 controls from non-cardiac departments. Propensity score matching was used to control for confounding variables such as age, sex, triglycerides, and blood pressure. After matching, 270 cases were matched with 270 controls. Univariate and multivariable conditional logistic regression analyses were performed on the matched data, and standard logistic regression was applied to the unmatched data. Statistical analysis was carried out using R software, version 4.0.1.
Results: Before matching, significant differences were observed between cases and controls in diabetes status, sex, age, triglycerides, and blood pressure. In the unmatched data, diabetes was strongly associated with coronary artery obstruction (OR = 4.962, 95% CI: 3.550–6.936, P < 0.0001). After propensity score matching, the odds ratio for diabetes remained significant but decreased in magnitude in the conditional logistic regression model (OR = 2.74, 95% CI: 1.888–3.9849). The marginal logistic regression model on the matched data also showed a significant association (OR = 2.51, 95% CI: 1.502–3.804).
Conclusion: Propensity score matching improved comparability between the case and control groups and provided a more accurate estimate of the association between diabetes and coronary artery obstruction. The findings indicate that diabetes remains an important risk factor for coronary artery disease, though effect estimates are smaller after adjustment for confounding.
Keywords
Healthy Aging Perspectives