Diabetes mellitus is known to be a major risk factor for the development of coronary artery disease (CAD). The aim of this study was to investigate angiographically the coronary arteries of diabetic persons, focusing on the type and distribution of CAD, sex differences in CAD anatomy, and the size of the coronary vessels. This was a randomized study and included two groups of patients with angiographically demonstrated CAD. Group A included 463 diabetics, aged 60.3 years, and Group B 210 nondiabetic patients, aged 58.5 years. The two groups were matched by age, sex, weight, and classic risk factors. The authors evaluated the regional location of CAD, left ventricular (LV) function, and the width of the lumen of coronary arteries. The diabetics had three-vessel disease more frequently (p<0.001) and one-vessel disease less frequently (p<0.001). The CAD was more extensive in Group A (mean 2.2 vessels, compared to 1.8 vessels in Group B, p<0.01). The right coronary artery was affected more often in diabetics (p<0.01), as was the anterior descending artery in three-vessel disease (p<0.05). The male diabetics had the same angiographic CAD severity as the females, although the latter had a better LV ejection fraction (p<0.05). The female diabetics < 55 years old had CAD findings comparable with those from women 4 years older in Group B. Diabetics show more diffuse and severe CAD than the general population. There are no sex-related differences in the severity of CAD.
SummaryBackgroundand hypothesis: Although it is well established that diabetes mellitus (DM) induces more severe coronary artery disease (CAD), it is not known whether it contributes to the development of coronary collateral circulation. The present study examines coronary Collateral Circulation in diabetic and nondiabetic patients with angiographically verified CAD.Methods: The study group consisted of 463 diabetic patients (382 men, 81 women) with a mean age of 60.3 f 8.8 years, and 227 nondiabetic subjects (159 men, 68 women) with a mean age of 59.2 f 9 years. The extension and functional capacity of coronary collateral circulation was assessed according to the Cohen and Rentrop grading system of 0 to III.Results: We found that diabetic patients had grade IIIcollateral circulation more frequently than nondiabetic subjects (13.2 vs. 8.5%, p
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