Correlation between coronary stenosis degree and reactive hyperemia index in patients with unstable angina pectoris complicating diabetes mellitus / 医学研究生学报

ABSTRACT

Objective Endothelial dysfunction is an important link in the development of coronary heart disease. The article aimed to evaluate reactive hyperemia index(RHI) level in patients with unstable angina pectoris(UAP) complicating diabetes mellitus(DM) and investigate its relationship with the degree of coronary artery stenosis. Methods TThe patients(n=300) diagnosed as UAP by coronary angiography (CAG) in our department were chosen and divided into DM group (UAP complicating DM, n=122) and NDM group(without DM, n=178). The severity of coronary artery stenosis was evaluated using the angiographic Gensini score. RHI levels were compared between two groups. Multiple linear regression analysis was used to analyze the correlations between RHI, angiographic Gensini score and risk factors. Results RHI level of DM group was found to be lower than that of NDM group(1.58±0.39 vs 1.70±0.24,P<0.05). Angiographic Gensini score was significantly elevated in DM group compared to NDM group[Gensini score(61.76±64.79) vs (37.00±29.79),P<0.05]. The RHI levels of patients with Gensini scores of 31-59 points(1.64±0.28)and above 60 points (1.58±0.32) were significantly lower than those with scores less than 30 points (1.78±0.23) (P<0.05). The RHI level of patients with coronary heart disease(CHD) with three or more risk factors (1.49±0.43) was significantly lower than that of CHD patients with two or less risk factors (1.63±0.29) (P<0.05). Fasting blood glucose, glycosylated hemoglobin, coronary Gensini score, smoking and risk factors in the combined group were all negatively correlated with RHI(β=-0.010；-0.001；-0.177；-0.126；-0.001). Conclusion Gensini integrals are closely co-related to the degree of endothelial dysfunction, and severe endothelial dysfunction may be one cause of exacerbated coronary stenosis in the patients with UAP complicating DM.