Angiographic severity and extent of coronary artery disease in patients with type 1 diabetes mellitus.
Studies of the characteristics of coronary artery disease (CAD) in diabetic patients have shown conflicting results. Only 2 studies exploring the severity of CAD, specifically in type 1 diabetes, have been published, and neither of them has used computer-aided quantitative coronary angiography. This retrospective study comprised 64 (24 women and 40 men) type 1 diabetic patients and nondiabetic control subjects. To estimate the severity, extent, and overall "atheroma burden" of CAD, we used quantitative coronary angiographic-based segmental analysis of coronary angiograms. Type 1 diabetic patients had greater global severity (p < 0.001), global extent (p < 0.001), and global atheroma burden (p < 0.001) indexes than nondiabetic control subjects. Quantitative coronary angiographic-derived indexes of CAD were, on average, 1.4- to 4.3-fold higher in diabetic than in nondiabetic patients. These differences were particularly marked in women. We found that type 1 diabetic patients with a clinical indication for coronary angiography, especially women, have more severe, extensive, and distal type of CAD than individually matched nondiabetic control patients. Our findings, including a loss of sex difference for CAD among type 1 diabetic patients and a marked impact of type 1 diabetes in women, are not explained by established risk factors.
Pajunen
P
P
Department of Medicine, Helsinki University Central Hospital, Finland.
Taskinen
M R
MR
Nieminen
M S
MS
Syvänne
M
M
D000328:Adult; D000704:Analysis of Variance; D017023:Coronary Angiography; D003327:Coronary Disease / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012727:Sex Characteristics; D012737:Sex Factors; D013599:Systole; D016277:Ventricular Function, Left