Clinical and coronary angiographic analysis of elderly patients with type 2 diabetes mellitus combined with coronary heart disease

Objective:To analyze the association of type 2 diabetes mellitus(DM) with the clinical and coronary angiographic features of coronary heart disease(CHD) in patients aged over 70 years old.Methods: A total of 310 elderly patients with coronary angiograph-confirmed coronary diseases,who were treated in Changhai Hospital during Apr.2006 to Jul.2008,were retrospectively analyzed.The patients were further divided into 2 subgroups according to the presence of DM: DM-CHD group(n=155) and non-DM-CHD group(n=155).The age,gender,blood pressure,blood lipid,ejection fraction(EF),the angiographic outcomes,etc.were analyzed and compared between the two groups.Results: The incidence of hypertension was significantly higher in the DM-CHD group than in the non-DM-CHD group(P0.05).The fasting blood glucose(FBG),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and fibrinogen(FIB) were significantly higher than those in the other group(P0.01),and the high density lipoprotein cholesterol(HDL-C) was lower than that in the other group(P0.05).The EF value in the DM-CHD group was significantly lower than that in the non-DM-CHD group(P0.01).Among the 35(22%) patients preliminarily diagnosed as having DM,14(40%) would be misdiagnosed if the diagnosis depends solely on FBG without oral glucose tolerance test(OGTT).The prevalence of diffusive coronary lesions in the DM-CHD group was significantly higher than that in the non-DM group(P0.01).DM-CHD group also had significantly higher coronary stenosis index(P0.01) and more occlusive vessels than non-DM-CHD group.Conclusion: The missed diagnosis rate of DM is high in CHD patients.Compared with non-DM-CHD patients,DM-CHD patients are at higher risks for coronary disease and have more severe coronary lesions.