Features of coronary atheroscl erotic lesions in diabetic patients w ith stable ischemic heart disease: a single-center, cross-secti onal study

Abstract

The aim was to study the features of coronary lesions in patients with stable ischemic heart disease (IHD) and concomitant type 2 diabetes mellitus (T2DM). Materials and methods. We conducted a single-center, cross-sectional study of 156 patients with stable IHD (98 men and 58 women, median age — 64 years). They were divided into 2 groups according to
the presence (n=59) or absence (n=97) of T2DM. Gensini score (GS) was used to assess the severity of coronary artery lesions. Results. Significantly larger numbers of cases of multivessel disease (35.6% vs 19.6%, p=0.042) and severe coronary atherosclerosis (GS>32) (40.7% vs 22.7%, p=0.027) were registered among patients with T2DM comparing to non-diabetic patients. This group of patients was characterized by a statistically more frequent presence of significant stenoses in the left circumflex artery (LCX) (45.8% vs 24.7%, p=0.011) and right coronary artery (RCA) (54.3% vs 33%, p=0.014). Diabetic patients had a larger number of stenotic coronary segments (2 (1-4) vs 1 (0-3), p=0.006). Obstructions in the mid segments of the LCX and RCA also were significantly more common in patients with IHD and T2DM (18.6% vs 6.2%, p=0.031, 35.6% vs 13.4%, p=0.002, respectively). Conclusions. Patients with stable IHD and concomitant T2DM had more severe atherosclerotic changes in the epicardial coronary arteries (according to the total number of diseased major vessels and GS) and were characterized by more common significant stenoses in the LCX and RCA, especially in their middle segments. It indicates an unfavorable course of coronary atherosclerosis in diabetic patients that’s why further research in this field is needed.