Background
Methods
Study population
Biochemical investigation
Angiography and analysis
Intracoronary pressure and collateral flow measurement
Statistical analysis
Results
Baseline characteristics
Variables | Diabetes (n = 220) | Non-diabetes (n = 220) | ||||||
---|---|---|---|---|---|---|---|---|
Mild (n = 99) | Moderate (n = 75) | Severe (n = 46) | P value | Mild (n = 132) | Moderate (n = 60) | Severe (n = 28) | P value | |
Male, n (%) | 94 (94.9) | 59 (78.7) | 24 (52.2) | < 0.001 | 127 (96.2) | 40 (66.7) | 14 (50.0) | < 0.001 |
Age, years | 57.9 ± 11.7 | 67.9 ± 10.7 | 73.7 ± 9.3 | < 0.001 | 61.3 ± 12.1 | 68.0 ± 9.3 | 74.6 ± 12.4 | < 0.001 |
Body mass index, kg/m2 | 25.4 ± 2.5 | 25.5 ± 2.6 | 25.9 ± 2.1 | 0.605 | 25.0 ± 2.5 | 25.0 ± 1.9 | 25.7 ± 2.4 | 0.294 |
Hypertension, n (%) | 102 (77.3) | 37 (61.7) | 7 (25.0) | < 0.001 | 91 (91.9) | 42 (56.0) | 11 (23.9) | < 0.001 |
History of dyslipidemia, n (%) | 23 (17.4) | 25 (41.7) | 14 (50.0) | < 0.001 | 2 (2.0) | 20 (26.7) | 26 (56.5) | < 0.001 |
Smoking, n (%) | 27 (27.3) | 26 (34.7) | 21 (45.7) | 0.090 | 43 (32.6) | 18 (30.0) | 15 (53.6) | 0.072 |
History of MI, n (%) | 19 (19.2) | 16 (21.3) | 19 (41.3) | 0.012 | 19 (14.4) | 12 (20.0) | 10 (35.7) | 0.030 |
Severity of CAD, n (%) | < 0.001 | < 0.001 | ||||||
1-vessel | 39 (39.4) | 2 (2.7) | 0 (0.0) | < 0.001 | 51 (38.6) | 5 (8.3) | 5 (17.9) | < 0.001 |
2-vessel | 35 (35.4) | 21 (28.0) | 17 (37.0) | 0.493 | 55 (41.7) | 17 (28.3) | 7 (25.0) | 0.089 |
3-vessel | 25 (25.2) | 52 (69.3) | 29 (63.0) | < 0.001 | 26 (19.7) | 38 (63.3) | 16 (57.1) | < 0.001 |
Multivessel disease | 60 (60.6) | 73 (97.3) | 46 (100.0) | < 0.001 | 81 (61.4) | 55 (91.7) | 23 (82.1) | < 0.001 |
Stenosis of PCDA, % | 37.6 ± 8.5 | 58.9 ± 5.3 | 83.4 ± 8.5 | < 0.001 | 33.5 ± 10.5 | 58.9 ± 5.4 | 82.6 ± 8.4 | < 0.001 |
Fast blood glucose, mmol/L | 6.3 ± 1.9 | 6.9 ± 2.2 | 6.5 ± 2.7 | 0.214 | 5.0 ± 0.7 | 4.7 ± 0.7 | 5.3 ± 0.6 | < 0.001 |
HbA1c, % | 7.2 ± 1.2 | 7.4 ± 1.5 | 7.1 ± 1.3 | 0.555 | 5.7 ± 0.4 | 5.7 ± 0.4 | 5.8 ± 0.4 | 0.980 |
Triglyceride, mmol/L | 1.55 ± 0.72 | 1.62 ± 0.63 | 1.68 ± 0.81 | 0.538 | 1.42 ± 0.71 | 1.45 ± 0.83 | 1.60 ± 0.71 | 0.521 |
Total cholesterol, mmol/L | 3.75 ± 1.04 | 4.11 ± 1.12 | 4.29 ± 1.04 | 0.009 | 4.11 ± 1.34 | 3.89 ± 1.45 | 4.08 ± 0.88 | 0.571 |
HDL cholesterol, mmol/L | 0.94 ± 0.20 | 0.99 ± 0.28 | 0.99 ± 0.16 | 0.312 | 1.01 ± 0.27 | 0.96 ± 0.19 | 1.00 ± 0.34 | 0.469 |
LDL cholesterol, mmol/L | 2.23 ± 0.90 | 2.47 ± 0.93 | 2.71 ± 0.87 | 0.010 | 2.49 ± 1.05 | 2.45 ± 1.11 | 2.40 ± 0.84 | 0.891 |
Serum creatinine, μmol/L | 85 ± 21 | 90 ± 30 | 110 ± 32 | < 0.001 | 77 ± 14 | 94 ± 27 | 102 ± 29 | < 0.001 |
Uric acid, μmol/L | 322 ± 79 | 315 ± 61 | 331 ± 76 | 0.515 | 337 ± 72 | 319 ± 96 | 339 ± 69 | 0.309 |
GFR, mL/min/1.73 m2 | 86.8 ± 18.5 | 75.5 ± 24.9 | 55.9 ± 20.6 | < 0.001 | 90.3 ± 15.8 | 70.7 ± 20.2 | 59.6 ± 21.8 | < 0.001 |
hsCRP, mg/L | 1.58 (0.66–3.32) | 2.46 (1.21–7.55) | 4.23 (1.44–17.15) | 0.031 | 0.97 (0.25–3.13) | 1.20 (0.27–10.35) | 2.66 (0.42–25.82) | < 0.001 |
LVEF, % | 60.5 ± 8.3 | 60.4 ± 9.3 | 54.7 ± 10.7 | 0.001 | 62.3 ± 9.0 | 61.3 ± 9.5 | 57.2 ± 12.8 | 0.042 |
Medication, n (%) | ||||||||
ACE inhibitors/ARBs | 53 (53.5) | 42 (56.0) | 26 (56.5) | 0.924 | 50 (37.9) | 20 (33.3) | 11 (39.3) | 0.798 |
β blockers | 41 (41.4) | 30 (40.0) | 20 (43.5) | 0.931 | 51 (38.6) | 25 (41.7) | 15 (53.6) | 0.345 |
Calcium channel blockers | 30 (30.3) | 23 (30.7) | 12 (26.1) | 0.845 | 41 (31.1) | 13 (21.7) | 8 (28.6) | 0.406 |
Nitrates | 57 (57.6) | 41 (54.7) | 24 (52.2) | 0.819 | 59 (44.7) | 32 (53.3) | 16 (57.1) | 0.339 |
Statins | 69 (69.7) | 59 (78.7) | 36 (78.3) | 0.328 | 77 (58.3) | 33 (55.0) | 12 (42.9) | 0.325 |
Anti-diabetic therapy | 58 (58.6) | 60 (80.0) | 40 (87.0) | < 0.001 | 0 (0.0) | 0 (0.0) | 0 (0.0) | – |
Aortic blood pressure, mmHg | ||||||||
Systolic | 150.2 ± 26.2 | 147.3 ± 23.4 | 141.2 ± 24.8 | 0.130 | 150.2 ± 29.2 | 147.0 ± 28.2 | 141.0 ± 17.9 | 0.260 |
Diastolic | 77.1 ± 9.8 | 74.9 ± 9.4 | 73.5 ± 10.8 | 0.093 | 78.1 ± 13.2 | 75.9 ± 9.7 | 75.6 ± 11.5 | 0.388 |
Mean | 101.5 ± 13.2 | 99.0 ± 11.8 | 96.1 ± 13.5 | 0.057 | 101.2 ± 14.7 | 101 ± 12.9 | 97.4 ± 7.7 | 0.407 |
Pd, mmHg | 52.1 ± 9.4 | 39.6 ± 11.0 | 32.5 ± 10.2 | < 0.001 | 53.6 ± 7.1 | 48.3 ± 8.6 | 35.6 ± 7.8 | < 0.001 |
Collateral flow index | 0.49 ± 0.09 | 0.36 ± 0.10 | 0.29 ± 0.09 | < 0.001 | 0.51 ± 0.08 | 0.45 ± 0.08 | 0.35 ± 0.08 | < 0.001 |
Collateral flow and BP
Effect of medical therapy
Multivariable analysis
Aortic BP | Mild | Moderate | Severe | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Diabetes (n = 99) | Non-diabetes (n = 132) | Pint | Diabetes (n = 75) | Non-diabetes (n = 60) | Pint | Diabetes (n = 46) | Non-diabetes (n = 28) | Pint | |||||||
β ± SE | P | β ± SE | P | β ± SE | P | β ± SE | P | β ± SE | P | β ± SE | P | ||||
Systolic | − 0.284 ± 0.073 | < 0.001 | − 0.352 ± 0.070 | < 0.001 | 0.325 | − 0.013 ± 0.062 | 0.840 | 0.065 ± 0.158 | 0.682 | 0.239 | 0.154 ± 0.204 | 0.464 | 0.025 ± 0.085 | 0.766 | 0.651 |
Diastolic | − 0.275 ± 0.079* | 0.001 | − 0.525 ± 0.065 | < 0.001 | 0.168 | − 0.019 ± 0.066# | 0.774 | − 0.303 ± 0.114 | 0.011 | 0.008 | 0.317 ± 0.087 | 0.001 | 0.199 ± 0.183 | 0.296 | 0.032 |
Mean | − 0.334 ± 0.074& | < 0.001 | − 0.540 ± 0.061 | < 0.001 | 0.081 | − 0.018 ± 0.063 | 0.779 | − 0.158 ± 0.136 | 0.253 | 0.067 | 0.604 ± 0.219& | 0.016 | 0.147 ± 0.087 | 0.008 | 0.669 |