Complications after One-Year Observation of Patients with Type 2 Diabetes Mellitus and Various Types of Coronary Heart Disease

Abstract

Aim: Evaluation of complications after one-year observation in patients with acute and chronic coronary heart disease (CHD) depending on the presence of type 2 diabetes mellitus (T2DM). Material and methods: This comparative clinical study included 202 men and women with acute and chronic CHD. Patients were divided into four groups, depending on the presence of type 2 diabetes mellitus: acute CHD and T2DM; acute CHD without T2DM (control group); chronic CHD and T2DM; chronic CHD without T2DM (control group). Depending on the results of clinical status and coronary angiography data, patients underwent myocardial revascularization (balloon angioplasty without stenting, stenting, coronary bypass grafting, stenting + coronary bypass grafting) followed by pharmacological treatment. One-year composite endpoints included: recurrent myocardial infarction, acute cerebrovascular accident, readmission, and death. Results: After admission, up to 80% of patients, regardless of CHD type and glycemic status, underwent revascularization. Patients without T2DM underwent stenting significantly more often compared with patients with T2DM. Coronary artery bypass grafting, including in combination with stenting, was more frequent in patients with T2DM with acute and chronic CHD. One year after discharge, readmissions and reoperations were more prevalent among patients with acute and chronic CHD and T2DM. The groups did not differ by the number of nonfatal and fatal complications. The total number of endpoints in patients with T2DM, regardless of the CHD type, were 2 times higher compared with the control group (p<0.001). Conclusion: Patients with acute and chronic CHD without T2DM, underwent stenting of one coronary artery more often, while patients with T2DM underwent coronary bypass surgery, including in combination with stenting. After one year of observation, the number of complications in patients with various CHD types and T2DM was higher than those without T2DM. This once again indicates the need for comprehensive secondary prevention.