Characteristics of Coronary Lesions in Small Vessel Disease Treated with Elective Stenting in Patients with Type 2 Diabetes Mellitus

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Background: The incidence of diabetes mellitus (DM) has suffered a dramatic increase and is a serious worldwide issue. Diabetes causes microvascular and macrovascular complications including coronary artery disease (CAD) that ultimately contributes to a high rate of cardiovascular morbidity and mortality.

Study aim: The aim of this study was to assess the factors associated with the atherosclerotic involvement of small coronary arteries as compared to large vessel disease, in patients with type 2 diabetes mellitus undergoing percutaneous stent coronary angioplasty.

Material and methods: Thirty-one patients who underwent Multislice 64 CT assessment of coronary lesions and stent implantation at the level of the significant coronary lesion were included in the study. CT-based Calcium Score was determined in all patients. Group 1 included patients with coronary lesions located on a vessel with a reference diameter above 3 mm (n = 24) and Group 2 included patients with a coronary lesion located on a vessel with a reference diameter below 3 mm (n = 7).

Results: The mean age of the study population was 62.25 ± 2.59 years in Group 1 and 64.28 ± 9.18 years in Group 2. Female gender was recorded in 38% of cases in Group 1 and in 14% of cases in Group 2. The left ventricular ejection fraction was below 45% in 13% of cases in Group 1 and in 29% of patients in Group 2. Bioabsorbable stents were implanted in 57% of coronary arteries suffering from small vessel disease, compared to 4% in the rest of the coronary arteries (p = 0.005). The Calcium Score was 552.45 ± 545.79 (95% CI: 354.41–694.64) in Group 1 compared to 1387 ± 1830.3 (95% CI: 305.85–3079.9) (p = 0.014).

Conclusions: The location of the atherosclerotic process at the level of the small coronary arteries is associated with a significantly higher Calcium Score at the level of the coronary tree, and with a higher rate of bioabsorbable stent implantation.

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