ABSTRACT
We investigated the incidence of in-hospital mortality or nonfatal myocardial infarction or nonfatal stroke in 216 patients with diabetes mellitus and in 552 patients without diabetes mellitus (68% men and 32% women, mean age 66 +/- 14 y) who underwent percutaneous coronary intervention with stenting. Symptomatic chest pain was present in 95% of diabetics and in 95% of nondiabetics. Unstable symptoms were present in 67% of diabetics and in 68% of nondiabetics. Aspirin was used in 99% of diabetics and nondiabetics. Clopidogrel was used in 98% of diabetics and nondiabetics. Beta blockers were used in 85% of diabetics and nondiabetics. Lipid-lowering drugs were used in 96% of diabetics and in 95% of nondiabetics. In-hospital mortality occurred in 2 of 216 diabetics (0.9%) and in 2 of 552 nondiabetics (0.4%), P not significant. In-hospital mortality or nonfatal myocardial infarction or nonfatal stroke occurred in 3 of 216 diabetics (1.4%) and in 6 of 552 nondiabetics (1.1%), P not significant.
Subject(s)
Angioplasty, Balloon, Coronary/mortality , Diabetes Complications , Hospital Mortality , Myocardial Infarction/etiology , Stroke/etiology , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary/adverse effects , Aspirin/therapeutic use , Case-Control Studies , Clopidogrel , Coronary Artery Disease/surgery , Female , Humans , Hypolipidemic Agents/therapeutic use , Incidence , Male , Middle Aged , Myocardial Infarction/epidemiology , Platelet Aggregation Inhibitors/therapeutic use , Risk Factors , Stents , Stroke/epidemiology , Ticlopidine/analogs & derivatives , Ticlopidine/therapeutic useABSTRACT
Coronary angiography was performed in 152 men and 163 women with diabetes mellitus, mean age 55 +/- 8 years, because of chest pain. Of 67 patients with 3-vessel or 4-vessel coronary artery disease (CAD), 17 (25%) were treated with diet alone, 29 (43%) with insulin, 18 (27%) with sulfonylureas, 12 (18%) with metformin, and 6 (9%) with thiazolidinediones. Of 76 patients with 2-vessel CAD, 20 (26%) were treated with diet alone, 36 (47%) with insulin, 21 (28%) with sulfonylureas, 21 (28%) with metformin, and 11 (14%) with thiazolidinediones. Of 40 patients with 1-vessel CAD, 15 (38%) were treated with diet alone, 11 (28%) with insulin, 8 (20%) with sulfonylureas, 12 (30%) with metformin, and 4 (10%) with thiazolidinediones. Of 132 patients with 0-vessel CAD, 18 (14%) were treated with diet alone, 21 (16%) with insulin, 7 (5%) with sulfonylureas, 75 (56%) with metformin, and 35 (26%) with thiazolidinediones. Cochran-Armitage trend tests were used to examine whether the use of treatment significantly increases or decreases as the number of arteries with CAD increases (P = 0.036 for diet alone; P < 0.0001 for insulin, for sulfonylureas, and for metformin; P = 0.002 for thiazolidinediones).
Subject(s)
Coronary Artery Disease/diet therapy , Coronary Artery Disease/drug therapy , Diabetes Mellitus/diet therapy , Diabetes Mellitus/drug therapy , Diet , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Metformin/therapeutic use , Sulfonylurea Compounds/therapeutic use , Thiazolidinediones/therapeutic use , Aged , Chest Pain/etiology , Coronary Angiography , Coronary Artery Disease/complications , Female , Humans , Male , Middle AgedABSTRACT
Coronary angiography was performed in 152 men and 163 women with diabetes mellitus (mean age 55 +/- 8 years) because of chest pain. The mean hemoglobin A(1c) level was 6.66 +/- 0.58% in 132 patients with 0-vessel coronary artery disease (CAD), 8.00 +/- 0.84% in 40 patients with 1-vessel CAD, 8.83 +/- 1.45% in 76 patients with 2-vessel CAD, and 10.40 +/- 2.28% in 67 patients with 3- or 4-vessel CAD. There was a significant increasing trend of hemoglobin A(1c) levels over the increasing number of vessels with CAD (p <0.0001).
Subject(s)
Coronary Artery Disease/blood , Diabetes Mellitus, Type 2/blood , Glycated Hemoglobin/metabolism , Angina Pectoris/blood , Angina Pectoris/complications , Angina Pectoris/diagnostic imaging , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/etiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnostic imaging , Female , Humans , Male , Middle Aged , Radiography , Severity of Illness IndexABSTRACT
Silent myocardial ischemia detected by exercise treadmill or pharmacologic sestamibi stress testing was present in 67 of 196 patients (34%) who had diabetes mellitus or impaired glucose tolerance and in 89 of 640 patients (14%) who had normal glucose tolerance (p <0.001). Among those who had diabetes mellitus or impaired glucose tolerance, silent myocardial ischemia was present in 27 of 54 patients (50%) who had a hemoglobin A1c level > or =7.6% and in 39 of 137 patients (28%) with a hemoglobin A1c level <7.6% (p <0.005).
