Angiographic evaluation of the effects of glucose metabolic status on progression of coronary artery lesions in patients with coronary artery disease.

ABSTRACT

BACKGROUND: The aim of the present study was to assess the effect of glucose metabolic status on the progression of coronary artery lesions in patients with coronary artery disease (CAD). METHODS: Two hundred and ninety-eight CAD patients who underwent coronary angiography were included in the study; follow-up angiography was performed after 9-15 months. The Gensini score, SYNTAX score, and the number of diseased vessels (at baseline and follow-up, as well as the change from baseline to follow-up) were used to determine the severity and progression of coronary artery lesions. The relationship between glucose metabolic status and progression of coronary artery lesions was investigated. Based on results of an oral glucose tolerance test, patients were divided into three groups normal glucose tolerance (NGT); impaired glucose regulation(IGR); and type 2 diabetes mellitus (DM). RESULTS: Compared with the NGT group, changes (from baseline to follow-up) in the Gensini score, SYNTAX score, and the number of diseased vessels were significantly higher in the IGR and DM groups. There were no significant differences between the IGR and DM groups. Multivariate regression analysis suggested abnormal glucose metabolism was an independent risk factor for greater changes in the Gensini and SYNTAX scores, as well as for a greater number of diseased vessels. CONCLUSIONS: Greater progression of coronary artery lesions is seen in patients with abnormal glucose metabolism (DM and/or IGR), even when levels of HbA1c are on target.