Histological and histochemical changes in the coronary arteries of old diabetic patients.

Abstract

In a study of the coronary arteries from 20 old diabetics and 20 old patients without clinical diabetes the following findings were obtained: — 1. The distal part of the extramural coronary artery from the diabetic patients contained more hyaline, PAS-positive material and fat in the intima than did that of the nondiabetic patients, but did not show a higher degree of metachromasia. — 2. There was more calcium in the proximal as well as in the distal part of the extramural coronary arteries in the diabetics than in the non-diabetics. — 3. Severe PAS-positive deposits were found in the smallest intramural branches much more often in diabetics than in non-diabetics. — 4. The PAS-positive substance did not react to staining for acid mucopoly-saccharides, glycogen, collagen, fibrin or reticulin. — 5. Endothelial proliferation was not observed in the small vessels with PAS-positive material. — 6. There was no measurable difference in the wall thickness of the smallest intramural vessels between the diabetic and non-diabetic patients. — 7. The incidence of PAS-positive small vessels of the myocardium was closely related to the incidence of nodular glomerulosclerosis in the kidney. There was no such relation to the blood pressure.