Features Of Coronary Angiography In Diabetes Mellitus With Acute Myocardial Infaction

Objective:To explore the features of coronary angiography in DiabetesMellitus(DM) with acute myocardial infarction(AMI)and the relationshipbetween diabetes mellitus and coronary atherosclerosis by coronary angiographyquantitative analysis . Methods:From Octobe 1998 to Octobe 2004,145 cases had had the firstthe acute myocardial infarction in six month without history of previouscoronary revascularization,coronary angiography were performed on atcardia medical department of the second hospital of the Shan Xi MedicalUniversity , the angiographic images were quantitatively analyzed byexperienced doctors in cardio angiography.Patients were divided into twogroups with diabetes mellitus and without diabetes mellitus according to the lastmodified diabetes mellitus diagnostic criteria of ADA and WHO .We hadanalyzed and compared two groups in the coronary score,extent score,stegnosis hierarchy total score,severity score,atherosclerotic score ,proximalsegment ,distal segment,vascular lesion ,vascular occlusion ratio.Coronarycollateral vessels of cases who had ≥75% stenosis were graded,we hadcalculated and compared the differents of the collat index number ,unfine collatindex number ratio and fine collat index number ratio in two groups, The oddsratio were calculated about diabetes mellitus and collateral circulation. Result: 104 patients were nondiabetes mellitus group with the mean age of59.81±12.42, 41 patients were diabetes mellitus group with the mean age of61.78±10.40.Nondiabetes mellitus group and diabetes mellitus group hadstatistical significance in fasting blood sugar ,hyperlipemia incidence rate,angina incidence rate and painless myocardial infarction ,the previous werehigher than the latter. there were no statistical significance in the age,sex,smoking ,hypertension in two groups,two groups were not significantdifference in myocardial infarction site. there were higher in diabetic mellitusgroup than in nondiabetic mellitus group(P<0.05) such as the coronary score,severity score,proximal segment,distal segment,and atherosclerotic score.Therewere significant difference in total score and extent score(P<0.01). Theincidence of multivessel coronary disease in diabetic mellitus group was higherthan in non-diabetic mellitus group , The result were significantdifference(P<0.01). nondiabetic mellitus subjects with coronary artery diseasecan develop more extensive coronary collateral circulation than diabetic mellituspatients.Odds ratio equal to 3.49 between diabetes mellitus and collateralcirculation. Conclusion: Diabetes Mellitus with acute myocardial infaction has thefeatures of higher atherosclerotic score, coronary angiography in DiabetesMellitus with acute myocardial infarction have three characters: (1) coronaryheart disease patients with diabetes mellitus have more severe changes inseverity,The stestenosis degree is above 75 percents.(2)disease extent is moredifussive , multivessel coronary lesion in diabetic mellitus group was higher(3)coronary collateral circulation cannot be development better.Odds ratio equalto 3.49 between diabetes mellitus and collateral circulation. There are evidentcorrelation in diabetes mellitus and collateral circulation.