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Severity of Coronary Atherosclerosis and Risk of Diabetes Mellitus.

Authors :: Colaiori I
Izzo R
Barbato E
Franco D
Di Gioia G
Rapacciuolo A
Bartunek J
Mancusi C
Losi MA
Strisciuglio T
Manzi MV
de Simone G
Trimarco B
Morisco C
Source :: Journal of clinical medicine [J Clin Med] 2019 Jul 21; Vol. 8 (7). Date of Electronic Publication: 2019 Jul 21.
Publication Year :: 2019
Abstract: Background: Cardio-vascular target organ damage predicts the onset of type 2 diabetes mellitus (DM) in hypertensive patients. Whether an increased incidence of DM is also in relation to the severity of coronary atherosclerosis is unknown.<br />Objective: We evaluated the onset of DM in relation to the extent and severity of coronary atherosclerosis, using the SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) score (SS), in patients with stable angina or acute coronary syndromes, referred for coronary angiography (CA).<br />Methods: Non-diabetic patients that underwent CA for the first time were included, and the SS was computed. Predictors of DM onset in low, medium, and high SSs were investigated.<br />Results: Five hundred and seventy patients were included, and the mean SS was 6.3 ± 7.6. During a median follow-up of 79 months (interquartile range (IQR): 67-94), 74 patients (13%) developed DM. The risk of DM onset was significantly higher in the patients with a medium or high SS (hazard ratio (HR)-95% confidence interval (CI): 16 (4-61), p < 0.0001; and 30 (9-105), p < 0.0001, vs low SS, respectively), even after adjustment for obesity, history of hypertension, impaired fasting glucose, and cardiovascular therapy.<br />Conclusions: The severity and extent of the coronary atherosclerosis, evaluated by the SS, is a strong and independent predictor of the development of DM in patients, referred to CA.