Macrovascular disease ( peripheral and coronary artery) in dibetic patients

Introduction: Diabetes mellitus is a major risk factor for cardiovascular disease. This paper is about obtaining a correlation between the degree of vascular disease and glycemic control, detection of early markers of macrovascular disease and establishing a relationship between peripheral vascular and coronary disease in diabetic patient. Methods: We used the data of the diabetic patients hospitalized between January 2012 and May 2014 in Internal Medicine I Clinic of Emergency Hospital “Sf. Ioan” Bucharest, that were investigated by coronarography and inferior limb arteriography. We also considered values of the basal glycaemia, HbA1c, creatinine and GFR evaluated by MDRD. Results: An 84 diabetic patients lot (76.2% M, 23.8% F), aged 42-82 years, with medium HbA1c 8.25% (5.9% -12.2%), 20 patients (23.8%) without coronary lesions, with 55% distal vascular disease, 30% femuro-popliteal,10% aorto-iliac; 25% with CKD st II, 65% st III and 10% st IV, 20 patients (23.8%) with single coronary lesion, with 35% disease of aorto-iliac axis, 65% of femuro-popliteal and 90% of distal vessels, 35% have CKD st II, 55% st III and 10% st IV, 2 coronary artery disease found in 16 patients (19.1%), 18.7% with aorto-iliac disease,75% femuro-popliteal, 87.5% distal vessel, with CKD st II 18.7%, st III 75% and st IV 6.3%, 28 patients (33.3%) with 3 coronary artery disease had 25% aortoiliac disease, 57.1% femuro-popliteal, 82.1% distal vessels disease, with CKD st II 39.2%, st III 50% and st IV 10.8%. Conclusions: The most common and earliest vascular injury occurs is in the trunk leg, being present in 78.6% of the group and over 70% of coronary lesions. Detection by noninvasive methods such as ankle-brachial index can be used as screening and risk assessment of coronary artery disease. Disease of the aortoiliac axis represents a negative predictive sign for coronary artery disease being present in a higher proportion to the patients with 3 coronary artery lesions and rare in those without lesions. HbA1c value did not vary significantly, being 7.7% in patients without coronary lesions and 8.05% in those with three-vessel lesions. Patients with multiple macrovascular lesions have 50% CKD III st.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)