 |
|
Prevalence of, and Risk Factors for, Angiographically Determined Coronary Artery Disease in Type I-Diabetic Patients With Nephropathy
Connie L. Manske, MD;
Robert F. Wilson, MD;
Yang Wang, MD;
William Thomas, PhD
Arch Intern Med. 1992;152(12):2450-2455.
Abstract
| |
• Background. —
Thirty-five percent of type I-diabetic patients are dead of coronary artery disease by age 55 years, and the risk of death is increased eightfold to 15-fold in patients with nephropathy. However, the prevalence of coronary artery disease with respect to age is unknown and few risk factors have been identified.
Methods.—
One hundred ten insulin-dependent diabetic patients underwent routine pretransplant coronary angiography and cardiac risk factor assessment. Angiograms were evaluated by two angiographers for presence or absence of coronary artery disease (CAD, defined as one or more coronary artery stenoses of 50% or greater in diameter, and no CAD, defined as no stenosis of 25% or greater in diameter, respectively). Prevalence of CAD by age was determined, and associated risk factors were defined.
Results.—
Fifty-two of 110 patients had CAD. Coronary artery disease prevalence increased significantly with age; 13 of 16 patients older than 45 years of age had CAD. For patients 35 years of age or younger, associated risk factors included a family history of premature myocardial infarction, higher hemoglobin A1C level, hypertension for more than 5 years, lower high-density lipoprotein level, and smoking for more than 5 pack-years. For patients between 35 and 45 years of age, associated risk factors included number of years of diabetes, higher hemoglobin A1C1C levels, and smoking more than 5 pack-years.
Conclusions.—
In type I-diabetic patients with nephropathy, CAD prevalence increased significantly with age and was found in the majority of patients older than 45 years of age. Coronary artery disease risk factors operative in the general population were significantly associated with CAD in this high-risk group. In addition, a role for hyperglycemia in accelerated atherogenesis was supported by the association of both higher hemoglobin A1c levels and number of years of diabetes with CAD.
(Arch Intern Med. 1992;152:2450-2455)
Author Affiliations
From the Department of Medicine, University of Minnesota School of Medicine (Drs Manske, Wilson, and Wang), and Department of Biostatistics, University of Minnesota School of Public Health (Dr Thomas), Minneapolis.
Footnotes
Accepted for publication June 8, 1992.
Reprint requests to Box 736, University of Minnesota Health Center, 516 Delaware St SE, Minneapolis, MN 55455 (Dr Manske).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Differences in Atherosclerotic Plaque Burden and Morphology Between Type 1 and 2 Diabetes as Assessed by Multislice Computed Tomography
Djaberi et al.
Diabetes Care 2009;32:1507-1512.
ABSTRACT
| FULL TEXT
Perioperative outcomes of cardiac surgery in kidney and kidney pancreas transplant recipients
John et al.
J. Thorac. Cardiovasc. Surg. 2007;133:1212-1219.
ABSTRACT
| FULL TEXT
Subclinical Coronary and Aortic Atherosclerosis Detected by Magnetic Resonance Imaging in Type 1 Diabetes With and Without Diabetic Nephropathy
Kim et al.
Circulation 2007;115:228-235.
ABSTRACT
| FULL TEXT
Coronary Artery Disease Is Common in Nonuremic, Asymptomatic Type 1 Diabetic Islet Transplant Candidates
Senior et al.
Diabetes Care 2005;28:866-872.
ABSTRACT
| FULL TEXT
Cardiovascular Risk Evaluation before Kidney Transplantation
Fishbane
J. Am. Soc. Nephrol. 2005;16:843-845.
FULL TEXT
A Common Promoter Polymorphism in the Hepatic Lipase Gene (LIPC-480C>T) Is Associated With an Increase in Coronary Calcification in Type 1 Diabetes
Hokanson et al.
Diabetes 2002;51:1208-1213.
ABSTRACT
| FULL TEXT
Stress Echocardiography for Risk Stratification of Diabetic Patients With Known or Suspected Coronary Artery Disease
Bigi et al.
Diabetes Care 2001;24:1596-1601.
ABSTRACT
| FULL TEXT
|
