Why the study?
Does small vessel disease compared to large vessel disease associate with different Calcium Scores and stent types in T2DM patients undergoing elective stenting?
Does small vessel disease compared to large vessel disease associate with different Calcium Scores and stent types in T2DM patients undergoing elective stenting?
In T2DM patients undergoing elective stenting, small vessel disease is associated with a significantly higher coronary Calcium Score and more frequent use of bioabsorbable stents compared to large vessel disease.
Small-vessel CAD in diabetes links to higher calcium scores; hypothesis-generating for bioabsorbable stent use, pending larger trials.
Background: The incidence of diabetes mellitus (DM) has suffered a dramatic increase and is a serious worldwide issue. Diabetes causes microvascular and macrovascular complications including coronary artery disease (CAD) that ultimately contributes to a high rate of cardiovascular morbidity and mortality. Study aim: The aim of this study was to assess the factors associated with the atherosclerotic involvement of small coronary arteries as compared to large vessel disease, in patients with type 2 diabetes mellitus undergoing percutaneous stent coronary angioplasty. Material and methods: Thirty-one patients who underwent Multislice 64 CT assessment of coronary lesions and stent implantation at the level of the significant coronary lesion were included in the study. CT-based Calcium Score was determined in all patients. Group 1 included patients with coronary lesions located on a vessel with a reference diameter above 3 mm (n = 24) and Group 2 included patients with a coronary lesion located on a vessel with a reference diameter below 3 mm (n = 7). Results: The mean age of the study population was 62.25 ± 2.59 years in Group 1 and 64.28 ± 9.18 years in Group 2. Female gender was recorded in 38% of cases in Group 1 and in 14% of cases in Group 2. The left ventricular ejection fraction was below 45% in 13% of cases in Group 1 and in 29% of patients in Group 2. Bioabsorbable stents were implanted in 57% of coronary arteries suffering from small vessel disease, compared to 4% in the rest of the coronary arteries (p = 0.005). The Calcium Score was 552.45 ± 545.79 (95% CI: 354.41–694.64) in Group 1 compared to 1387 ± 1830.3 (95% CI: 305.85–3079.9) (p = 0.014). Conclusions: The location of the atherosclerotic process at the level of the small coronary arteries is associated with a significantly higher Calcium Score at the level of the coronary tree, and with a higher rate of bioabsorbable stent implantation.
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Alina et al. (2016) studied this question.
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