Coronary Angiography Evaluation of Atherosclerosis in Diabetic Patients

摘要

Background Atherosclerosis is chronic disease, the prevalence of which has increased steadily as the population ages. We assessed prevalence, quality, and extent of coronary atherosclerosis using coronary angiography in a group of diabetic patients compared to nondiabetic patients. Methodology One hundred patients with suspected coronary artery disease underwent coronary angiography of the right coronary artery (RCA) and the left coronary artery (LCA) and were tested for the differences between diabetic (50) and non-diabetic (50) patients in ischemia detection by this method. All patients underwent coronary angiography in Heart Centre of the Clinical Center University of Sarajevo in period from January 2012 to January 2015. Coronary angiography was performed in the right and left anterior oblique position. Results Significant differences in sedentary lifestyle, and hypertension were seen among the diabetic and the non-diabetic group. Development of critical and diffuse coronary artery lesions was significantly higher among diabetics than non-diabetics. Changes in the proximal segment of the left anterior descending artery were the most common finding in diabetic patients. Stenotic atherosclerotic lesions of the large coronary arteries were significantly more common in the left than in the right coronary artery, but the difference between the diabetic and the non-diabetic group did not reach statistical significance. The most frequently atherosclerotic lesion of the RCA was seen in the middle segment, rarely in the proximal and distal part. Conclusion Diabetic patients were found to have a significantly higher prevalence of stenotic atherosclerotic lesions of the coronary arteries. Diabetes significantly affects the anatomy of coronary arteries, and is associated with age, sedentary lifestyle, and hypertension. These findings may prove clinically useful in the follow-up of diabetic patients, the choice of diagnostic procedures as well as in active treatment either by atherectomy or by percutaneous angioplasty and stenting.