Angiographic severity and extent of coronary artery disease in patients with type 1 diabetes mellitus

Studies of the characteristics of coronary artery disease (CAD) in diabetic patients have shown conflicting results. Only 2 studies exploring the seve rity of CAD, specifically in type 1 diabetes, have been published, and neit her of them has used computer-aided quantitative coronary angiography, This retrospective study comprised 64 (24 women and 40 men) type 1 diabetic pat ients and nondiabetic control subjects. To estimate the severity, extent, a nd overall "atheroma burden" of CAD, we used quantitative coronary angiogra phic-based segmental analysis of coronary angiograms. Type 1 diabetic patie nts had greater global severity (p <0.001), global extent (p <0.001), and g lobal atheroma burden (p <0.001) indexes than nondiabetic control subjects, Quantitative coronary angiographic-derived indexes of CAD were, on average , 1,4- to 4.3-fold higher in diabetic than in nondiabetic patients. These d ifferences were particularly marked in women. We found that type 1 diabetic patients with a clinical indication for coronary angiography, especially w omen, have more severe, extensive, and distal type of CAD than individually matched nondiabetic control patients, Our findings, including a loss of se x difference for CAD among type 1 diabetic patients and a marked impact of type 1 diabetes in women, are not explained by established risk factors. (C ) 2000 by Excerpta Medica, Inc.