Occurrence and Progression of Coronary Artery Disease in Patients with Type 2 Diabetes

Aim. The aims of reaserch project were to determine the predictive role of diabetes type 2 as independent factor and/or in correlation with others in occurrence, extent and prognosis of CAD, as well as to evaluate the feasibility, safety and the effect of an aggressive control of risk factors, multifactoral medicament therapy and application of revascularization procedures in individuals prone to or with already manifested diabetes. Material and methods. The research covered prospectively 30 individuals with type 2 diabetes (age 53.3 + 3.1, mean diabetes duration 7.5 years) with presence of insulin resistance syndrome’s componentes and retrospectively/ prospectively 333 patients with manifested diabetes type 2 and CAD (age 60.4 + 8.23, mean diabetes duration 8.5 years). Results. History of myocardial infarction corelates with obesity and hypoHDLemia. Dyslipidemia with the presence of chest pain in objective clinician state, and symptom of angina grade CCS3 correlates with presence of microvascular complications, and CCS1 angina with use of insulin in diabetes treatment. Gensini score, angiographicly estimated, was in multivariate relation with dyslipidemia and systolic pressure. Among pts undergone coronary surgery as predictor of by pass graft stenosis was found physical inactivity, and among pts undergone percutaneus revascularization, carotid IMT for in stent restenosis. Conclusions. High prevalence of insulin resistance syndrome’ components: arterial hypertension and dyslipidemia were found in type 2 diabetes patients, who did not presented CAD. Symptomatic CAD, occurred in 6.7% od these pts was only in relation with the hypoHDLemia.