title: Association of prediabetes with diffuse coronary narrowing and small-vessel disease.
abstract: BACKGROUND
  A significant number of patients may not benefit from conventional techniques of myocardial revascularization due to diffuse coronary artery disease (CAD) or small coronary arterial sizes because of smaller arteries causing anastomotic technical difficulties and poor run-off. Diabetic patients have a more severe and diffuse coronary atherosclerosis with smaller coronary arteries limiting the possibility to perform a successful and complete revascularization, but this has not been examined in prediabetics.
  
  
  OBJECTIVE
  To evaluate whether there is an association between prediabetes and the coronary arterial size.
  
  
  METHODS
  We prospectively studied 168 consecutive patients with CAD and 172 patients with normal coronary artery anatomy (NCA). Patients were divided into three groups according to hemoglobin (Hb) A1c levels as "normal," "prediabetic," and "diabetic" groups, and the coronary artery sizes and Gensini scores were analyzed.
  
  
  RESULTS
  There were 78 female patients and 90 male patients in the CAD group, and 87 female patients and 85 male patients in the NCA group. There was a statistically significant difference in distal and proximal total coronary arterial size among the CAD and NCA groups for both genders. There was a positive correlation between the HbA1c subgroups and Gensini score (Spearman's ρ: 0.489, p<0.001 in female group; Spearman's ρ: 0.252 p=0.016 in male group).
  
  
  CONCLUSIONS
  We found that prediabetic patients have a smaller coronary size and diffuse coronary narrowing for both genders, particularly in distal coronary arterial tree of left anterior descending coronary artery. The early detection of prediabetes in daily cardiology practice may provide more appropriate coronary lesion for percutaneous or surgical revascularization.
authors.affiliation: Acibadem University, Department of Cardiology, Eskisehir, Turkey.
authors.forename: Cagatay
authors.initials: C
authors.lastname: Ertan
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: ozcanozeke@gmail.com.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Ozeke
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Gul
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Dursun
authors.initials: D
authors.lastname: Aras
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Topaloglu
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Halil Lutfi
authors.initials: HL
authors.lastname: Kisacik
authors.affiliation: Acibadem University, Department of Cardiology, Eskisehir, Turkey.
authors.forename: Ahmet Duran
authors.initials: AD
authors.lastname: Demir
authors.affiliation: Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Aydogdu
authors.affiliation: Baskent Universitesi, Department of Cardiology, Ankara, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozin
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011236:Prediabetic State / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Coronary artery size; Diffuse coronary narrowing; Prediabetes