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Study Of Coronary Angiographic Features And Endothelial Function In Patients With Coronary Heart Disease And Hyperglycemia

Posted on:2008-10-02Degree:DoctorType:Dissertation
Country:ChinaCandidate:L WangFull Text:PDF
GTID:1104360212487710Subject:Internal Medicine
Abstract/Summary:PDF Full Text Request
1.Study on the prevalence of abnormal glucose metabolism and clinical features in patients with coronary artery diseaseObjective To investigate the situation of abnormal glucose metabolism and clinical features in patients with coronary artery disease. Methods Scheduled hospital admitted inpatients with CAD in cardiology department of the first hospital affiliated to Shanxi Medical College and the second hospital affiliated to PLA general hospital were consecutively recruited from Aug.2005 to Aug.2006,201 cases data were collected by means of a case record form (CRF). 38 patients were previously diagnosed diabetes mellitus. 163 CAD patients performed OGTT to characterize the glucose metabolism status. BMI, blood lipids, blood pressure and other clinical features were studied. Results 163 CAD patients were performed OGTT,44 cases were diagnosed as DM, 59 cases were IGT,15 cases were IFG, 5 cases were IGT and IFG,and 40 cases with normal glucose tolerance.Among all CAD patients, total abnormal glucose metabolism made up 80.1%. Compaired with normal glucose metabolism, DM and IGT group showed significant BMI,WC and blood lipids abnormality.2.The clinical and coronary angiographic features in patients with type 2 diabetes mellitus combined with CHDObjective This study was designed to investigate the clinical and coronary angiographic features in patients with type 2 diabetes mellitus combined with coronary heart disease. Methods A total of 143 cases confirmed by coronary angiography weredivided into two groups according to the status if they had combined with type 2 diabetes mellitus or not. 75 cases type 2 diabetes mellitus patients accompanied by coronary heart disease and 68 cases with coronary heart disease were studied. The clinical features including height, weight, BMI, blood pressure, plasma lipids were investigated, and the coronary features were obtained through coronary angiography. Results Higher triglyceride and lower high-density lipoprotein cholesterol and abnormal blood pressure were found in the group of type 2 diabetes mellitus combined with coronary heart disease compaired with the control group,and showed significant statistic meaning((P<0.05). The result of coronary angiography showed that patients with type 2 diabetes mellitus combined with coronary heart disease suffered from severe coronary lesions, severe stenosis of coronary artery.3.Coronary angiographic features in patients with impaired glucose tolerance combined with CHDObjective To investigate the clinical and coronary angiographic features in patients with impaired glucose tolerance combined with CHD. Methods A total of 163 cases with coronary heart disease were performed 75g OGTT, and 44 cases were diagnosed as diabetes, 59 cases were diagnosed as IGT, 40 cases were normal glucose. 59 IGT cases and 40 NGT cases were studied. the coronary features were obtained through coronary angiography. Results The result of coronary angiography showed that the coronary multivessel changes and the severity of coronary artery stenosis were more frequent in IGT group than in control group. In IGT and NGT group, single vessel lesions were 25.42% vs 57.5%,and two vessels lesions were 32.2% and 15.0% respectively. Multiple blood vessel lesions were 55.2% in IGT group, while 37.5% in NGT group (P <0.05).As to the extent of stenosis, >75% were 65.6% in IGT group vs 46.77% in NGT group, showed significant statistic difference(P<0.05).4.The study of vWF, PAI-1 and adiponectin level in coronary heart disease patients with hyperglycemiaObjective To investigate the level of von willabrand factor (vWF),Type 1 plasminogen activator inhibitor (PAI-1) and adiponectin in coronary heart disease patients with hyperglycemia Methods A total of 163 cases with coronary heart disease were performed 75g OGTT, and 44 cases were diagnosed as diabetes mellitus(26.99%), 59 cases were diagnosed as impaired glucose tolerance (24.38%), 15 cases were impaired fasting glucose (7.46%), 40 cases were normal glucose (24.54%).The level of vWF, PAI-1 and adiponectin were measured by ELISA from diabetes mellitus group, impaired glucose tolerance group, impaired fasting glucose and normal glucose group. Results vWF level increased in DM group and IGT group compaired with NGT group, and showed significant statistic meaning (P<0.05); PAI-1 level increased in DM group, and showed significant statistic meaning (P<0.05);adiponectin level of IGT and DM group were higher than that of NGT group, and showed significant statistic meaning (P<0.05)Conclusions1. the frequency of abnormal glucose metabolism is considerably more common than normal glucose regulation in patients with any manifestation of CAD. Significant abnormal body weight and dislipidemia existed in CAD patients with abnormal glucose metabolism, Prevalence of abnormal glucose metabolism should be obviously underestimated by FPG only. OGTT easily discloses the glucometabolic status and should be a routine procedure in diagnosis of such patients.2. Blood lipids disorder mainly found in patients with type 2 diabetes mellitus combined with coronary heart disease and played an important role in the severity of coronary artery lesions. Severe coronary lesions were found in type 2 diabetes mellitus combined with coronary heart disease.3. impaired glucose tolerance were found to be related to the severity of coronary artery lesions.4. Hyperglycemia cause high vWF and PAI-1 level, and low adiponectin level, which lead to severe endothelial lesion. It is essential to discover and control hyperglycemia as early as possible to prevent the appearance and development of coronary heart disease.
Keywords/Search Tags:Coronary artery disease, abnormal glucose metabolism, Oral glucose tolerance test, coronary heart disease, type 2 diabetes mellitus, coronary angiography, Impaired Glucose Tolerance, Coronary Heart Disease, Coronary Angiography
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