Endocrine Abstracts

Type 2 diabetes (T2D) is an independent risk factor for coronary heart disease (CHD). CHD in patients with T2D develops at an earlier age and is characterized by severe damage to the distal coronary arteries.

Materials and Methods: A cross-sectional controlled study of 50 hospitalized cardiac patients with chronic CHD was conducted to assess the effect of T2D on the condition of the coronary arteries using coronary angiography. The main group: patients with CHD and T2D, age-68.5±9.63 years (women-44.12%, men-55.88%). The comparison group: patients with CHD without T2D, age–69.5±13.14 years (women–43.75%, men–56.25%).

Results: Patients of both groups were comparable in gender, age (P>0.05), laboratory data: cholesterol, TG, HDL, VLDL, AST, ALT, creatinine, total protein (P>0.05) in blood serum. The blood glucose level in patients of the main group was significantly higher compared to the comparison group (6.8 (5.5-8.5) vs 5.5 (5.2-6.0) mmol/l, P=0.01). HbA1c=7.7±1.73% in patients of the main group, the experience of T2D according to the anamnesis was 8.2±3.14 years. The HbA1c level in patients of the main group was 7.7±1.73, which indicates insufficient control of T2D. According the coronary angiography results, hemodynamically significant stenosis involving coronary arteries peripheral parts were identified in 43.7% of patients in the comparison group: in the left coronary artery, right coronary artery, anterior interventricular branch, circumflex branch, diagonal branch, obtuse edge branch. In 79.4% of patients in the main group the number of hemodynamically significant stenosis involving peripheral parts was identified in the left coronary artery, circumflex branch, diagonal branch, and obtuse margin branch, and right coronary artery, anterior and posterior interventricular branches. The results indicate a significant increasing of hemodynamically significant stenosis involving the peripheral parts of the coronary arteries in patients with CHD and T2D (χ2 = 6.4, P=0.012). The higher prevalence and depth of the pathological process was recorded in patients with CHD and T2D.

Conclusions: The results of the study show an increasing prevalence of the coronary atherosclerosis confirmed by coronary angiography in patients with coronary heart disease and type 2 diabetes compared with patients with coronary heart disease without type 2 diabetes by 35.7%. More severe coronary atherosclerosis was identified in patients with coronary heart disease and type 2 diabetes, included hemodynamically significant stenosis involving predominantly peripheral parts of the coronary arteries, caused by the development of atherosclerotic plaques and arterial tortuosity, which is likely due to diabetic angiopathy against the background of chronic hyperglycemia.