| Background and Purpose Type 2 diabetes is common in modern society, the number of patients with diabetes being around 150 million in China. Diabetes has been considered a major risk factor of atherosclerosis. The incidence of coronary artery disease was even higher for males compared to females (1.2 to 3.4 folds), and mortality was also significantly increased in diabetic patients. Around 70 to 80% of diabetic patients died of cardiovascular diseases. Previous reports have shown diffuse coronary lesions in diabetic patients. The rapid progression of coronary atherosclerotic disease may be related to hyperinsulinemia, lipid metabolic disorder, hyperglyceremia or hypertension. The purpose of this study was to assess the characteristics of coronary artery disease in type 2 diabetes patients.Materials and MethodsStudy population Forty-five patients who had a typical history of diabetes and angiographically-documented coronary disease were included (diabetes group), 32 men and 13 women with a mean age of 53+5 years (ranging from 48-78 years). The duration of diabetes was ranging from 6 months to 15 years ( average 5.2+3.7 years). Another 45 patients without diabetes who underwent coronary angiography at the same time period served as controls (control group), 29 men and 16 women with a mean age of 57+6 years (ranging from 34 to 80 years).Clinical assessment Detailed information including body mass, height, and.4.risk factors for coronary disease (hypertension, smoking and family history of coronary disease) were recorded for each patient. Serum lipid profile was assessed (cholesterol, triglyceride, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], glucose, uric acid, C-reactive protein).Coronary angiography Coronary arteriography was performed using a standard Judkins technique, and the extent and degree of coronary stenosis were evaluated visually by two independent cardiologists. The degree of stenosis was expressed as percentage reduction of coronary diameter and was considered mild (<50% stenosis), moderate (50-75% stenosis) or severe (75-99% stenosis) or total occlusion. The number of diseased coronary vessels was also recorded, and multivessel disease was diagnosed if two or more major coronary arteries were involved. The site of the coronary lesion was classified as proximal, mid, or distal according to the standard method, and diffuse coronary disease was defined as long lesion (>2cm), multiple stenotic lesions (more than 2 stenoses) in the same coronary artery. The morphology of coronary lesion was also graded based on standard classification, with complex lesions being those with multiple irregularities of vascular wall, thrombus formation or ulceration.ResultsThere were no significant differences in age, sex, and occurrence of smoking and family history of coronary artery disease between the two groups. However, serum concentration of total cholesterol, triglyceride, LDL-C was higher and that of HDL-C was lower in the diabetes group than in the control group. The number of patients with hyperuricemia and hypertension was also significantly increased in the diabetes group..5.The occurrence of single vessel disease, two vessel disease and triple vessel disease was 8(17.8%), 12 (26.5%) and 25 (55.5%) in the diabetes group and was 30 (66.7%), 10 (22.2%) and 5 (11.1%) in the control group, resulting in a significantly higher incidence of triple vessel disease in the former group (p<0.001).The distribution of coronary artery lesions was similar between the diabetes and control groups.Of 107 diseased coronary arteries in the diabetes group, mild stenosis was in 17 (15.9%), moderate stenosis in 12 (11.2%), severe stenosis in 67 (62.6%), total occlusion in 11 (10.3%). However, of 65 diseased coronaries in the control group, mild stenosis was in 18 (27.7%), moderate in 8 (12.3%), severe in 31 (47.7%), and total occlusion in 8 (12.3%). The diabetes group patients had significant higher incidence of severe coronary disease than the control gr...
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