Title: Percutaneous transluminal coronary angioplasty in coronary artery disease in patients with type 2 diabetes mellitus
- Jan Z. Peruga, Wojciech Religa, Maria Krzemińska-Pakuła, Józef Drzewoski
- Original articles
- Polish Journal of Cardiology
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- Final page:
- diabetes, ischemic heart disease, percutaneous intervention
Epidemiologie studies have clearly proven that diabetes mellitus accelerates atherosclerosis, leading to more severe course of ischemic heart disease when compared to non-diabetic subjects. The aim of the study was the analysis of PTCA in CAD patients with or without diabetes. In a three-year period, between 1998 and 2000, 1570 PTCA procedures were performed in the Cardiology Department, Internal Medicine Insti-tute, Medical University of Łódź. The patients were divided into two groups: group 1 - PTCA patients with normal glucose metabolism (n=1303) and group 2 - PTCA (267 patients, 17%) who had type II diabetes mellitus. Both group were similar in terms of age, but not of gender distribution. Men was great in non diabetic group 81 % vs. 73% (p<0.05), The history of previous myocardial infaretion more often in patients with diabetes 43% vs. 32% (p<0.05).
Diabetic patients were more often found to have multivessel disease 38% vs. 13% (p<0.05) and the reference diameter of stenotic vessel was significantly smaller in patients with diabetes 3.12±0.4 vs. 3.4±0.5 (p<0.05) Stent implantation was also morę often in diabetic subjects (40% vs. 34% (p<0.05). Earlycomplicationsratesand mortality were similar in both groups. Mean follow-up time (exceeding 1 year) was comparable in both groups. Total mortality in whole group was 4.07%, but was significantly greater in diabetic group 5.24% vs. 3.83%, p<0.005.
Prognosis after the intervention was worse in diabetic than in non-diabetic patients. After PTCA, diabetic patients suffered significantly more often from myocardial infaretion, symptoms of unstable angina, and recurrent or new coronary stenosis. They also required repeated angiography more often than patients without diabetes.