Study of coronary artery lesions in hypertensive patients with and without diabetes

Abstract

Objectives: To investigate the imaging characteristics of coronary artery lesions in hypertensive patients with or without diabetes by percutaneous coronary angiography. Determining the relationship between cardiovascular risk factors and levels of coronary artery damage in patients with hypertension. Methods: A cross - sectional description was carried out in 185 hypertensive patients (49 with diabetes; 136 without diabetes) underwent percutaneous coronary angiography to assess lesion images at the Emergency - Interventional Cardiology Department - Hue Central Hospital and the Cardiology Department - International Medical Center, Hue Central Hospital from April 2020 to July 2021. Results: Characteristics of coronary artery damage in hypertensive patients by percutaneous coronary angiography: the proportion of patients with significant coronary artery stenosis accounted for 64.90%. Significant lesions in the LAD: 63.20%; RCA: 45.40%, LCx: 35.70% and LM: 1.10%. The coronary artery lesions in patients with diabetes were diffuse, complex, and more severe than in the non - diabetic group, with an average number of obstructive branches over 50% and over 70% in two groups with and without diabetes, respectively. 39 ± 1.81; 1.90 ± 1.57 and 1.71 ± 1.60; 1.40 ± 1.33. The degree of atherosclerosis was more diffuse with a higher Gensini index of 34.22 ± 25.73; 29.59 ± 27.76. The average Syntax score was 10.82 ± 9.00; in the group of patients with diabetes and without diabetes, respectively, 14.32 ± 10.12; 8.67 ± 8.24. Significant coronary artery damage was not related to age, sex, obesity, hypertension class, smoking. Patients with dyslipidemia had a rate of coronary artery stenosis of more than 2.78. Hypertensive patients with diabetes had a higher rate of coronary artery damage 4.72 times. In multivariate analysis with two risk factors, both dyslipidemia and diabetes were independent risk factors for coronary stenosis greater than 70%. Conclusions: Coronary lesions in patients with diabetes were characterized by diffuse, multi - branch, and complex effects. Dyslipidemia and diabetes were two risk factors that independently affect the degree of significant coronary artery injury.