Clinical Analysis Of Relationships Among Impaired Glucose Tolerance,Carotid Atherosclerosis And Coronary Heart Disease

Objective:Observe coronary and carotid arteries lesion characteristics on patients with coronary heart disease combine impaired glucose tolerance.Further analysis about hazards and potential predictors of serious coronary artery on patients with coronary heart disease combine impaired glucose tolerance.Methods:Select hospitalization patients imitate to diagnose coronary artery lesion from Aug 2014 to July 2015 in The first affiliated hosipital of University of South China,in which 175 patients were diagnosed by Coronary Angiography(the CAG).They were devided into three groups according to their blood glucose level:impaired glucose tolerance group(IGT group,n=63);diabetes group(DM group,n=50);euglycemia group(NGR group,n=64).Make record of the routine clinical data,as gender,age,smoking history,hypertension history,blood biochemistry and the routine clinical data,record the coronary stenosis site and degree of coronary artery stenosis,Consummate carotid artery B-ultrasonography,record average carotid intima-media thickness(CIMT) and weather combine carotid plaque.Compare differences about routine clinical data,coronary artery lesion characteristics,CIMT,carotid plaque and make further Logistic regression analysis on coronary artery disease risk factors of the IGT group.Discuss the dependence and differences about characteristics of coronary artery lesion and CIMT,carotid plaque on patients with coronary heart disease and IGT.Result:1.There is no statistical differences of the total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) between IGT group and DM group. But NGR Group's TC and LDL-C are much higher than the last two groups,the data has statistical differences(p<0.05).The age,gender,hypertension history,smoking history,BMI,TG of patients have no statistical differences in the three groups. 2.The comparation of characteristics of coronary artery lesion:1)Comparation of Gensini aggregate score,there is no statistical differences between IGT group 40(17,52) and DM group 41.5(21.75,55.25).But NGR group's 11.5(6.25,31) are much higher than last two groups,the data has statistical differences(p<0.001).2)The light,moderate and severe coronary artery lesions checked percentage of IGT group is 26.2%,23%,50.8%,while DM group is 22%,20%,58%,NGR group is 65.6%,17.2%,17.2%.Among them,we can conclude that light lesion checked less in DM and IGT group than NGR group(p<0.001),but there is no statistical differences between IGT group and DM group;there is no statistical differences among the three groups of moderate coronary artery lesions;but severe lesion checked less in NGR group than IGT and DM group(p<0.001),but there is no statistical differences between IGT group and DM group 3)The single-vessle,double-vessle and triple vessel coronary artery lesions checked percentage of IGT group is 26.2%,27.9%, 45.9%,while DM group is 20%,28%,52%, NGR group is 62.5%,17.2%,20.3%.Single-vessle lesion checked in DM and IGT group have no statistical differences between them;there is no statistical differences among the three groups of double-vessle coronary artery lesions;but triple vessel lesion checked less in NGR group than IGT and DM group(p<0.05),but there is no statistical differences between IGT group and DM group. 4)Coronary artery diffuse lesions checked percentage of IGT group,DM group and NGR group is 73.8%,74%,42.19%,while vascular stricture or occlusion lesions of the three groups is 19.67%,28%,4.69%. The data of NGR group is much less than IGT group and DM group(p<0.05),but there is no statistical differences between IGT group and DM group.3.The contrast of CIMT and carotid plaque:1)There is no statistical differences between IGT group(1.08±0.26mm) and DM group(1.11±0.22mm).The data of NGR group(0.94±0.20mm)is much less than IGT group and DM group(p<0.05).2)110 carotid plaques were discovered in all the groups,the percentage was 62.9%,while in IGT group,DM group and NGR group is 67.2%,82%,43.8%.The data of NGR group is much less than IGT group and DM group(p<0.05),but there is no statistical differences between IGT group and DM group. 4.The analysis of risk factors in IGT group:Result of Logistic regression analysis suggest:BMI is an independent risk factor of coronary severe lesions in patients with coronary heart disease combine IGT.CIMT may be an independent predictor for coronary artery severe lesions and vascular occlusion lesions.Carotid plaque probably can predict diffuse lesion independently. 5.ROC curve suggest:the best diagnose point of tangency for severe coronary artery lesions in coronary heart disease with IGT is 1.125 mm. The area under the curve is 0.8,the sensibility is 67.7%,the specificity is 76.7%.Conclusion:1.Impaired glucose tolerance has relations with atherosclerosis,its hazardous nature is similar to DM.We should pay close attention to impaired glucose tolerance in Patients with coronary heart disease.2. CIMT and carotid plaque may be part of the predictive factors of coronary severe lesions on patients with coronary heart disease.Carotid B-ultrasound can be one of the reliable methods to filter and reexamine patients with coronary heart disease.