Correlation between microvascular complications and severity of coronary artery disease in patients with type 2 DM

Background:Patients suffering from type 2 diabetes (T2DM) have a 2–6 times higher risk of dying from cardiovascular disease than people without diabetes. While macrovascular disease is the main pathogenic mechanism behind coronary artery disease in the general population, microvascular disease may play a significant role in the development of CAD in diabetics. Coronary artery disease is a leading cause of mortality in diabetics. Microalbuminuria to chronic kidney disease (CKD) can result from diabetic nephropathy, which is caused by persistently poor glycemic management. It is unclear how microalbuminuria and cardiovascular disease are related, but one theory suggests that it has to do with the growing transvascular leakiness of albumin in the systemic and renal arteries. A well-known micro-angiopathic consequence of DM with a strong correlation to cardiovascular risk factors is diabetic retinopathy.
Objectives:To assess the association between the microvascular complications and the severity of CAD determined by coronary angiography in patients with T2DM.
Patients and Methods: This study was conducted on 70 cases with T2DM who were admitted for coronary angiography due to suspected CAD and then divided into 41 patients diagnosed with nephropathic,and 29 non-nephropathy patients. Then Patients were divided into retinopathic and non-retinopathic groups 36 patients diagnosed with retinopathy and 34 non-retinopathic patients. All patients were subjected to full history, clinical examination, lab investigations and cardiac catheterization using the Genseni score system to detect the severity of coronary artery disease.
Results: Gensini score was significantly higher in the nephropathy group compared to the non-nephropathy group. The Vessel score was insignificantly different between the two groups. Gensini score was significantly higher in the retinopathy group compared to the non-retinopathy group. Vessel score was significantly higher in the retinopathy group compared to the non-retinopathy group.
Conclusion: In patients with type 2 DM subjected to coronary angiography because of suspected (CAD), duration of DM, creatinine, HbA1c, and Gensini score were significantly higher in the nephropathic group compared to the non-nephropathic group. Further, duration of DM, HbA1c. Gensini score and vessel score were significantly higher in the retinopathy group compared to the non-retinopathy group. Microvascular diabetic complications with retinopathy and nephropathy were significantly associated with the severity of CAD determined by coronary angiography.