Cagatay Ertan1, Ozcan Ozeke2, Murat Gul3, Dursun Aras3, Serkan Topaloglu3, Halil Lutfi Kisacik3, Ahmet Duran Demir1, Sinan Aydogdu3, Bulent Ozin4. 1. Acibadem University, Department of Cardiology, Eskisehir, Turkey. 2. Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: ozcanozeke@gmail.com. 3. Turkiye Yuksek Ihtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey. 4. Baskent Universitesi, Department of Cardiology, Ankara, Turkey.
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). CONCLUSION: 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.
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. Diabeticpatients 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). CONCLUSION: We found that prediabeticpatients 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: Alberto Boi; Ankush D Jamthikar; Luca Saba; Deep Gupta; Aditya Sharma; Bruno Loi; John R Laird; Narendra N Khanna; Jasjit S Suri Journal: Curr Atheroscler Rep Date: 2018-05-21 Impact factor: 5.113
Authors: Vichai Senthong; Xinmin S Li; Timothy Hudec; John Coughlin; Yuping Wu; Bruce Levison; Zeneng Wang; Stanley L Hazen; W H Wilson Tang Journal: J Am Coll Cardiol Date: 2016-06-07 Impact factor: 24.094