ความรุนแรงของเส้นเลือดโคโรนารี จากการฉีดสีของผู้ป่วยเบาหวานชนิดไม่พึ่งอินสุลินที่มีและไม่มีจอประสาทตาแบบโพรลิเฟอร์เรทิฟหรือไตวาย / จุลชาติ ภัทรศิริกุล = Severity of coronary angiographic study in NIDDM patients with and without proliferative diabetic retinopathy or renal failure / Chulachart Patrasirikul
Objective : Compared with nondiabetic patients, patients with noninsulin dependent diabetic mellitus (NIDDM) have more extensive and diffused atherosclerotic disease. Whether NIDDM patients with proliferative diabetic retinopathy (PDR) or renal failure have more extensive and diffused atherosclerotic disease than NIDDM patients without PDR and renal failure have not been well characterized. The objective of this study is to compare the severity of coronary angiogram (CAG) in NIDDM patients with PDR or renal failure with NIDDM patients without these two complications. Research design and methods : Data on baseline clinical and angiographic characteristics of 59 NIDDM patients with PDR or renal failure and 83 NIDDM patients without PDR and renal failure in King Chulalongkorn Memorial Hospital from November, 1999 to November, 2000 were analyzed. These NIDDM patients underwent coronary angiogram due to acute coronary syndrome or results of noninvasive test and had been routinely evaluated eye ground by opthalmologist. Results : NIDDM patients with PDR or renal failure had longer duration of NIDDM, higher systolic BP than NIDDM patients without PDR and renal failure. On angiographic characteristic, NIDDM patients with PDR or renal failure (n= 59) had left main disease (n = 3;5.1%), TVD (n = 31;52.5%), DVD (n = 16;27.1%), SVD (n = 8;13.55), normal or nonsignificant lesion (n = 1;1.6%). NIDDM patients without PDR and renal failure (n = 83) had left main disease (n = 3;3.6%), TVD (n = 32;38.5%), DVD (n = 25;30.1%), SVD (n = 21;25.3%), normal or nonsignificant (n = 31;52.5%). Both groups of patients are not different in prevalence of tripple vessle disease and left left main disease. However, NIDDM patients with PDR or renal failure had much more mean+-SD of total lesions, total significant lesions, RCA lesions, RCA significant lesions, obtuse marginal 1 lesions, obtuse marginal 1 significant lesions, proximal RCA lesions, proximal RCA significant lesions and total of lesions in distal vessels (distal portion of coronary arteries+diagonal brance+obtuse marginal branch+posterior descending artery) than NIDDM patients without PDR and renal failure. Conclusions : Both groups of NIDDM patients have no statistically significant difference in prevalence of left main disease and triple vessel disease. However, the presence of PDR or renal failure in NIDDM patients are associated with more multiple lesions and multiple significant lesions.