Coronary artery disease incidence between type II diabetic and non-diabetic patients with Leriche syndrome.
BACKGROUND
Coronary artery disease (CAD) is the major determinant of preoperative morbidity and mortality for patients requiring major vascular surgery. The management of CAD in these patients is controversial.


OBJECTIVE
The incidence and severity of CAD in diabetic and non-diabetic patients with Leriche syndrome was explored.


METHODS
107 patients with Leriche syndrome were selected as major vascular occlusion and grouped according to their diabetic Status. Sex, age, dyslipidemia, obesity, hypertension, clinic cardiac status, coronary angiographic lesions and coronary revascularisation procedures were noted.


METHODS
Patients' demographics, intra-operative and per-operative data were recorded and compared. In every patient with Leriche syndrome scheduled for elective vascular reconstruction coronary angiography was performed. Lesions were evaluated for the percentages of stenosis. Preliminary coronary bypass or percutaneous coronary intervention was recommended for those found to have advanced or severe CAD. Results of revascularisation procedures were compared.


METHODS
Chi-square or Fisher exact chi-square test is used for conditional variables. Independent samples was analysed by using t-test. Kruskal-Wallis variance test was used if the variances are not homogeneous according to the Levene test.


RESULTS
No difference was found in both groups except family history and obesity. Coronary angiographic investigation indicates that 59% of DIAB group and 38% of NONDIAB group patients have advanced or severe CAD which has a high probability for myocardial revascularization. Overall revascularisation rate is 37.8% in DIAB group and 45.7% in NONDIAB group (p=0,641). Preoperative mortality was found 2.7% in diabetics and 4.2% in non-diabetics (p=0.342).


CONCLUSIONS
Leriche syndrome with diabetes mellitus is more likely to have advanced coronary disease than those without diabetes mellitus. Coronary angiography and subsequent revascularisation should be performed only in those patients who require major vascular surgery.
Ozeren
Murat
M
Cardiovascular Surgery Department, Social Security Organization, Ankara Education and Research Hospital, Turkey. mozeren@yahoo.com
Kaya
Mehmet
M
Kar
Mustafa
M
Yücel
Ertan
E
Durmaz
Tahir
T
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D006801:Humans; D007925:Leriche Syndrome / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D014421:Turkey