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

Am J Cardiol. 2000 Nov 15;86(10):1080-5. doi: 10.1016/s0002-9149(00)01163-2.


Studies of the characteristics of coronary artery disease (CAD) in diabetic patients have shown conflicting results. Only 2 studies exploring the severity of CAD, specifically in type 1 diabetes, have been published, and neither of them has used computer-aided quantitative coronary angiography. This retrospective study comprised 64 (24 women and 40 men) type 1 diabetic patients and nondiabetic control subjects. To estimate the severity, extent, and overall "atheroma burden" of CAD, we used quantitative coronary angiographic-based segmental analysis of coronary angiograms. Type 1 diabetic patients had greater global severity (p < 0.001), global extent (p < 0.001), and global 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 differences were particularly marked in women. We found that type 1 diabetic patients with a clinical indication for coronary angiography, especially women, have more severe, extensive, and distal type of CAD than individually matched nondiabetic control patients. Our findings, including a loss of sex 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Coronary Angiography*
  • Coronary Disease / classification
  • Coronary Disease / complications*
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / physiopathology
  • Diabetes Mellitus, Type 1 / complications*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Radiographic Image Enhancement
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index*
  • Sex Characteristics
  • Sex Factors
  • Systole
  • Ventricular Function, Left