Clinical Characteristics And Coronary Lesions Of Patients With Coronary Artery Disease Complicated With Type 2 Diabetes Mellitus

Background: Patients with type 2 diabetes mellitus usually are discovered complicated with coronary heart disease(CHD) more easily,some people propose that diabetes mellitus (DM)should be seen as the same dangerous as CHD. The artherosclerosis of patients with DM develops progressively,and more people suffers from heart events than patients without DM .DM and CHD have the same backgrounds,that is insulin resistance and hyper insulinemia,so that we can presume that there are some correlations between DM and CHD.The metabolic disorders render patients with DM higher risk of suffering from CHD.The glycosylated hemoglobin(HbA1c) is an effective and convenient index of the monitoring of the blood glucose. Discovery, diagnosis and cure of DM,by the control the level of HbA1C to decrease the complication of CHD.Objectives: (1)Study the correlations between clinical indexs and CHD,including blood glucose ,blood pressure,blood lipoprotiein ,urea nitrogen and creatinine ;(2)study if control the HbA1c level can improve the coronary disease;(3)study impaired fasting glycaemia(IFG) and impaired glucose tolerance(IGT) if have the correlations to coronary disease.Methods: (1)All the 462 patients needed to test the level of blood glucose. Whether the patients were complicated with DM were based on DM history and 1999 WHO diagnostic criteria of DM.Then classified them into DM group(112) and non-DM group(350). All patients needed to measure the level of urea nitrogen,creatinine, uricacid, cholesterol,triglyceride,high density lipoprotein,low density lipoprotein in blood;(2)Partial of the patients from non-DM group(178) underwent glucose tolerance test(OGTT Test),and were classified into OGTT abnormal group(58) and OGTT normal group(120),then compared their differences in situation of the coronary disease; (3)Every patient with DM needed test the HbA1c and were classified into controlled(47) and non-controlled(65) groups,and compared their differences in situation of the coronary disease;Results:(1)There were significant differences in ages and family history of hypertension and DM andCHD.DM patients were liable to smoking(68.4% vs. 41.1%,P<0.01).There were not significant differences between men and women;(2)There were differences in triglyceride(1.90±0.75 vs. 1.57±0.92,P<0.05),high density lipoprotein(0.72±0.13 vs. 1.38±0.83,P<0.01) and uricacid (378.5±94.1 vs.330.7±85.1,P<0.01)between DM group and non-DM group;(3)The changes of coronary arteries of Patients of DM group were severer than non-DM group;more multi-vessel diseases(33.0% vs. 12.9%,P<0.01) and more triple vascular lesions,right and left circumflex artery changes are found;(4)There are statistic significances in blood lipid VLDL-C(0.68±0.23 vs. 0.80±0.20,P<0.05) between glucose controlled group and non controlled group. HbA1c non controlled group has more severe coronary diseases than controlled group;(5) The changes of coronary arteries of Patients of OGTT abnormal group were severer than OGTT normal group ,more multi-vessel diseases(34.5% vs. 21.7%,P<0.01) and more triple vascular lesions,right artery changes are found.Conclusion:(1)Patients of type 2 DM had more risks of coronary artery diseases and were liable to having family history and smoking .The metabolic disorder of lipid were severer and the same to the changes of coronary arteries;(2) HbA1c non controlled group has more severe coronary diseases then controlled group;(3) The changes of coronary arteries of Patients of OGTT abnormal group were severer than OGTT normal group ,more multi-vessel diseases and more triple vascular lesions,right artery changes are found.