The Pathological Characteristics In Coronary Heart Disease Patients With Diabetes Mellitus-the Study Of Intravascular Ultrasound And Coronary Angiography

Objective: To understand coronary artery lesions in coronary heart disease patients with diabetes mellitus according to coronary angiography and intravascular ultrasound examination. To explore the application value of intravascular ultrasound in coronary heart disease patients with diabetes mellitus.Method: 90 cases of coronary heart disease patients were selected in the Department of Cardiology in the First Affiliated Hospital of Wangnan Medical College from 2012 January to 2014 November. The diabetes mellitus group were 38 cases, Non diabetes mellitus group were 52 cases. Patients’ clinical data、coronary angiography and intravascular ultrasound image were collected. Image analysis was performed by two experts who know the things. Then clinical data and image results were analyzed. The general clinical data and laboratory results of diabetic and non‐diabetic patients with coronary heart disease were compared. The results of coronary angiography and IVUS quantitative, qualitative analysis results in diabetic and non‐diabetic patients with coronary heart disease were compared. ROC curve analysis forecast the application value of fasting blood glucose in the stenosis vascular lumen and minimal lumen diameter in diabetes patients with coronary artery disease.Results: There were no differences in age 、 s moking 、 d rinking 、 h ypertension and previous myocardial infarction in diabetic and non‐diabetic patients with coronary heart disease(P>0.05). Triglyceride in diabetic group with coronary heart disease was higher than non‐diabetic group with coronary heart disease(P<0.01). The incidence of double vessel and multi vessel disease in diabetic group with coronary heart disease was higher than non‐diabetic group with coronary heartdisease(P<0.05). The incidence of the anterior descending branch lesion、circumflex branch lesion and right coronary artery lesions in diabetic group with coronary heart disease was higher than non‐diabetic group with coronary heart disease(P<0.05). The incidence of severe stenosis rate in diabetic group with coronary heart disease was higher than non‐diabetic group with coronary heart disease(P<0.05). The most narrow blood vessel lumen area 、 maximum diameter and minimum diameter in diabetic group with coronary heart disease was less than non‐diabetic group with coronary heart disease(P<0.05). Plaque burden in diabetic group with coronary heart disease was more than non‐diabetic group with coronary heart disease(P<0.05). The incidence of hard plaque in diabetic group with coronary heart disease was higher than non‐diabetic group with coronary heart disease(P<0.05). ROC curve analysis results of fasting blood glucose prediction in the most narrow blood vessel lumen area show: the AUC was 0.638, the optimal threshold was 4.770mmol/L, the sensitivity was 84.62%, the specificity was 50.10%. ROC curve analysis results of fasting blood glucose prediction in the stenosis vascular lumen diameter show: the AUC of 0.701, the optimal threshold was 5.585mmol/L, the sensitivity was 52.63%, the specificity was 80%.Conclusions:(1) Triglyceride in diabetic group with coronary heart disease was higher than non‐diabetic group with coronary heart disease.(2) The incidence of double vessel and multi vessel disease in diabetic group with coronary heart disease was higher. The incidence of the anterior descending branch lesion 、circumflex branch lesion and right coronary artery lesions in diabetic group with coronary heart disease was higher. The incidence of severe stenosis rate in diabetic group with coronary heart disease was higher.(3) The most narrow blood vessel lumen area、 maximum diameter and minimum diameter in diabetic group with coronary heart disease was less than non‐diabetic group with coronary heart disease. Plaque burden in diabetic group with coronary heart disease was more than non‐diabetic group with coronary heart disease. The incidence of hard plaque in diabetic group with coronary heart disease was higher.(4) Fasting blood glucose has a certain value in predicting the most narrow area in the lumen of blood vessels andthe minimal lumen diameter.