Characteristics Of Coronary Arterial Lesions In Type 2 Diabetic Coronary Artery Disease-the Study Of Coronary Angiography And Intravascular Ultrasound

OBJECTIVES Aimed to explore characteristics of coronary artery in angina with type 2 diabetes using coronary angiography and intravascular ultrasound, it would provide to assistance for the prevention and treatment of the type 2 diabetic angina patients.METHODS A total of 152 patients who would comply with CAD(angina) clinical and coronary angiographic diagnosis criteria,and the same time finished examination of coronary angiography and intravascular ultrasound, patients were divided into two groups according to the WHO diabetes criteria (1999),56 of whom were diabetics and 96 were nodiabetics. Two groups of patients collected below data:clinical data included in gender, age, height, weight, smoking, drinking, hypertension, coronary artery disease, family of cardiovascular disease; biochemical data included in fasting plasma glucose(FPG),postprandial 2h plasma glucose, total cholesterol(TC),triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C); Coronary angiography imaging analysis included disease arteries, number of disease arteries, narrow degree of coronary artery, lesions type; Intravascular ultrasound imaging analysis included in plaque properties, external elastic membrane area of lesion site(EEM CSA), the lumen area, the plaque burden, the eccentric index, the remodeling index(RI), the remodeling incidence. The clinical feature and the data from coronary angiography and intravascular ultrasound were compared between diabetic and nodiabetic angina patients.RESULTS In diabetic group, fasting plasma glucose(FPG) was significantly increased (P<0.001),postprandial 2h plasma glucose was significantly increased(P<0.001), triglyceride(TG) was significantly increased(P=0.008) more than nodiabetic group; The right coronary artery was significantly more frequently involved in diabetics (62.5% vs 38.5%, p=0.004). three-vessel lesions involved in diabetic patients were more frequently(44.7%vsl8.8%,p=0.001), and nodiabetic patients had one-vessel lesions more frequently (45.8% vs 19.6%, p=0.002),diabetes patients had severe stenosis(75%-99%) more frequently(42.8% vs 21% P=0.004) than nodiabetes, and same time diabetic patients had type C lesions more frequently (46.5%vs 20.8% P=0.001),.Diabetic patients had calcified plaque more common (23.2% vs 8.3% P=0.01), more over diabetic patients had plaque rupture more common (19.6% vs 6.2% P=0.011), In diabetic patients, the lumen area was significantly reduced(3.63±1.01mm2 vs 4.62±1.81mm2 P<0.001), the plaque burden was significantly increased(75.15±8.46% vs 64.75±11.56% P=0.033) more than nodiabetes, Diabetic patients had less RI(0.96±0.15 vs 1.00±0.10 P<0.001),The negative remodeling was more common(50.0% vs 23.0% P=0.001) than nodiabetes.CONCLUSIONS:1 The right coronary artery lesions was significantly more frequently in angina with type 2 diabetes.2 Coronary arterial lesions in angina with type 2 diabetes had more multi-vessel lesions and was more severe and more complex.3 About morphology of plaque in angina with type 2 diabetes, calcified plaques and plaque ruptures were more detected.4. Coronary arterial negative remodeling in angina with type 2 diabetic was more common...