Anatomic Pattern of Coronary Artery Disease

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Autopsy and angiographic studies have shown that patients with diabetes more frequently have left main coronary artery lesions, multivessel disease, and diffuse CAD. A recent angiographic study on 534 patients with angina demonstrated that the greater the impairment of glucose metabolism (i.e., normal, IGT, newly diagnosed diabetes, or known diabetes), the smaller the average vessel diameter and longer the coronary lesions.30 It is common belief that diabetic patients have an impaired ability to develop coronary collaterals compared with nondiabetic counterparts. However, a recent study measuring coronary collateral flow using intracoronary pressure

Years

Figure 2-3. Coronary artery disease (CAD) mortality over 18 years according to the status of diabetes (DM) and prior myocardial infarction (MI). (From Juutilainen A, Lehto S, Ronnemaa T, et al: Type 2 diabetes as a "coronary heart disease equivalent": An 18-year prospective population-based study in Finnish subjects. Diabetes Care 2005;28:2901-2907.)

Years

Figure 2-3. Coronary artery disease (CAD) mortality over 18 years according to the status of diabetes (DM) and prior myocardial infarction (MI). (From Juutilainen A, Lehto S, Ronnemaa T, et al: Type 2 diabetes as a "coronary heart disease equivalent": An 18-year prospective population-based study in Finnish subjects. Diabetes Care 2005;28:2901-2907.)

and Doppler guidewires did not find differences between diabetic and nondiabetic patients in the setting of stable CAD.31 Finally, intravascular ultrasound (IVUS) studies have shown that coronary arteries of diabetic patients are less likely to undergo favorable remodeling—an early compensatory enlargement at atherosclerotic sites—in response to atherosclerosis.

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Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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