Impact of diabetes mellitus on severity of concomitant peripheral arterial occlusive disease in patients with coronary artery disease.
OBJECTIVE
The aim of the study was to evaluate the impact of Diabetes Mellitus (DM) on severity of concomitant Peripheral Arterial Occlusive Disease (PAOD) in patients with Coronary Artery Disease (CAD).


METHODS
This study included 302 patients (229 men) with a mean age of 62.2 +/- 11.5 years who had angiographically documented CAD. Patients were divided into Group I (severe CAD), Group II (moderate CAD) and Group III (mild CAD). Each of the groups I-III was divided into subgroups comprising diabetic patients (subgroups Ia, IIa, IIIa) and non-diabetic patients (subgroups Ib, IIb, IIIb). PAOD was evaluated by measurement of Toe-Brachial Index (TBI).


RESULTS
PAOD was diagnosed in 69 patients (22.8%). Symptoms of PAOD (intermittent claudication or rest pain) were present in 38 patients (55%), while 31 patients (45%) were asymptomatic. Frequency of symptoms attributable to PAOD did not differ (p = 0.43) between diabetic patients (25 out of 49 patients, 51%) and non-diabetic patients (13 out of 20 patients, 65%). TBI was significantly (p = 0.04) lower in diabetic (0.41 +/- 0.03) than in non-diabetic patients with PAOD (0.51 +/- 0.03). This significant difference was found in each of the Groups I-III. Severity of PAOD was significantly associated with angiographic gravity of CAD, both in diabetic (p = 0.046) and in non-diabetic patients (p = 0.047).


CONCLUSIONS
DM has an adverse impact on severity of concomitant PAOD in patients with CAD. This impact does not depend on angiographic gravity of CAD. However, the association between severity of PAOD and angiographic gravity of CAD is demonstrated both in diabetic and in non-diabetic patients.
Papanas
N
N
Second Department of Internal Medicine, Democritus University of Thrace, Greece. papanasnikos@yahoo.gr
Tziakas
D
D
Maltezos
E
E
Kekes
A
A
Hatzinikolaou
E
E
Parcharidis
G
G
Louridas
G
G
Hatseras
D
D
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000453:epidemiology*; D015897:Comorbidity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged