New diagnostic criteria for diabetes and coronary artery disease: insights from an angiographic study

Abstract

In patients with type 2 diabetes, those with 7.0 mM/L < or = fasting plasma glucose < 7.7 mM/L have a slightly greater prevalence of mildly severe lesions that may partly explain their higher cardiovascular event rate.

Coronary anatomy and left ventricular ejection fraction in patients with type 2 diabetes admitted for elective coronary angiography

“…Our study is the first that used established scores of the atherosclerotic burden determined by angiography in a large study population. The present findings of more severe coronary artery disease with higher atherosclerotic scores on angiography in patients with diabetes are confirmed in two recently published investigations by Ledru et al [14] and Natali et al [22], as well as two epidemiological studies [23,24] that also found a more severe and diffuse coronary atherosclerosis in diabetic patients. The higher rates of diffuse disease found in these studies is in line with the higher frequency of three-vessel disease and the presence of peripheral coronary artery disease in our study population.…”

“…However, there is some controversy in this regard in the literature. Whereas Ledru et al [14] found similar results as in our registry, there are other reports that could not demonstrate a significant difference in the severity of coronary artery disease between diabetic patients and patients without diabetes [15,20,21]. The much smaller number of patients investigated compared to the present study may explain this discrepancy.…”

“…Relevant coronary artery stenosis was defined as stenosis Ͼ 50%. In addition, a more sophisticated scoring system was used to assess the atherosclerotic burden of each individual patient as described previously [14,17]: each of the nine segments was graded as follows: grade 0, angiographically normal segment; grade 1, Ͻ 50% stenosis; grade 2, 50 -75% stenosis; grade 3, 75-99% stenosis; and grade 4, occlusion. Three scores were used to describe coronary atherosclerosis.…”

“…However, previous studies have provided controversial results regarding the association between the severity of coronary artery disease and the presence of DM [12][13][14][15]. Therefore, the aim of the present study was to assess the prevalence and severity of coronary artery disease in the largest cohort of diabetic patients yet studied in comparison with nondiabetic patients, consecutively referred to our center between 1990 and 2000.…”

Pulse hypertension: a new component of the metabolic syndrome in elderly women?

“…36 Another possibility is the higher prevalence of glucose intolerance in our female population, a condition preceding frank diabetes. 37 Increasing evidence shows that the gender-specific difference in CHD mortality decreases with age, and women with MS experience the greater risk. 38 Of course, we have observed a population in which a natural selection has occurred in the previous decades, a selection that is notoriously more important in men, more prone to succumb to MS.…”