Diabetes mellitus and Metabolic syndrome, both are established risk factors for CAD. In our study, we tried to compare the effects of these two diseases individually as well as their combined effect.Methods: we performed an Observational, cross-sectional, hospital-based, single center study on 240 patients presenting at our hospital with chest pain. we assessed the severity of CAD with Syntax score and divided the study population into three groups with SS of <=22, 23-32 and >=33.Results:

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... tically significant difference was found in each of the first three groups of combined MS plus DM, only MS without DM, only DM without MS when compared with the fourth group of nondiabetics nonmetabolic syndrome patients. Strongest difference was found between patients with combined diabetes and metabolic syndrome with those who had none of these (<0.001). Thus, complexity of CAD is much severe in patients who have diabetes and/or metabolic syndrome.Conclusions: Patients having diabetes mellitus and/or metabolic syndrome are found to have more severe form of coronary artery disease than those who don't have either of these. However, presence of both diabetes and metabolic syndrome has not been found to impose any significant additional risk than their isolated presence.