Significance hyperglycemia in the development and progression of coronary atherosclerotic lesions

Abstract

The purpose of research — to evaluate the relationship of carbohydrate metabolism (glucose serum and glycosylated hemoglobin) with the presence and severity of coronary artery lesions in patients with coronary heart disease  (CHD) and diabetes mellitus (DM) type 2 and without it, and their importance in the diagnosis of  atherosclerotic lesions of the coronary vessels. Materials and methods. 131 patients with CAD (89 men, 42 women), mean age of 59.6±9.11 years were examined.  Depending on the presence of T2DM patients with CAD were divided into 2 groups: 1st group (n=70) — patients with concomitant T2DM, 2nd group (n=61) — patients  with CAD without T2DM. All patients were performed coronary angiography to verify the diagnosis of coronary artery disease. Also were assessed the levels of blood  glucose by oxidase method and glycosylated hemoglobin (HbA1c) by chromatographic method. Results. The study demonstrated the positive correlation between the  experience of diabetes  and the number of atherosclerotic plaques of coronary vessels (r=0.5; p<0.00001), the number of diseased coronary vessels (r=0.5; p<0.000001),  weak between diabetes experience and the number of diseased coronary artery segments (r=0.45; p=0.00001), number of hemodynamically significant  coronary stenoses (r=0.32; p=0.0073). It was also established the presence of a weak positive correlation between serum levels of glucose and the amount of coronary  atherosclerotic plaques (r=0.28; p=0.001), the amount of diseased coronary vessels (r=0.27; p=0.002), the number of affected segments coronary artery (r=0.27;  p=0.002). The glycosylated hemoglobin was associated average positive correlation with the number of atherosclerotic lesions of the coronary vessels (r=0.68;  <0.000001), strong — with the number of diseased coronary vessels (r=0.70; p<0.000001), the number of affected segments of the coronary arteries (r=0.70;  <0.000001). Conclusions. The findings of the study results demonstrate an adverse effect disorders of carbohydrate metabolism on the development and progression  of atherosclerosis. Determination of long-term compensation marker of diabetes type 2 — HbA1c is important both in predicting of atherosclerotic  lesions of the coronary vessels and the diagnostic of hemodynamically significant  coronary artery stenosis, diffuse coronary lesions.