Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2025; 16(4): 99151
Published online Apr 15, 2025. doi: 10.4239/wjd.v16.i4.99151
Coronary imaging characteristics and risk factors in patients with type 2 diabetes mellitus with coronary heart disease complication
Chang-Jie Pan, Tao Wang, Ruo-Han Yin, Xiao-Qiang Tang, Chun-Hong Hu
Chang-Jie Pan, Chun-Hong Hu, Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Chang-Jie Pan, Tao Wang, Ruo-Han Yin, Xiao-Qiang Tang, Department of Radiology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou 215006, Jiangsu Province, China
Author contributions: Pan CJ, Wang T and Hu CH designed the study and were involved in the data acquisition and writing of this article; Pan CJ, Yin RH, Tang XQ and Hu CH contributed to the analysis of the manuscript; and all authors have read and approved the final manuscript.
Supported by the Science and Technology Major Project of Changzhou Science and Technology Bureau, No. CE20205047; Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2022D01F52; and Changzhou A Major Scientific Research Project of the Municipal Health Commission, No. ZD202220.
Institutional review board statement: This study was approved by the Ethic Committee of The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University (No. 2020KY149-01).
Informed consent statement: All patients provided written informed consent for participation in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Hong Hu, PhD, Department of Radiology, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215006, Jiangsu Province, China. hchsdfyy2024@163.com
Received: September 12, 2024
Revised: December 10, 2024
Accepted: January 18, 2025
Published online: April 15, 2025
Processing time: 169 Days and 2.8 Hours
Abstract
BACKGROUND

Coronary heart disease (CHD) is a prevalent type 2 diabetes mellitus (T2DM) complication. Further, the risk stratification before angiography may help diagnose T2DM with CHD early. However, few studies have investigated the coronary imaging characteristics and risk factors of patients with T2DM complicated with CHD.

AIM

To compare the differences in coronary imaging between patients with T2DM with and without CHD, determine the risk factors of T2DM complicated with CHD, and establish a predictive tool for diagnosing CHD in T2DM.

METHODS

This study retrospectively analyzed 103 patients with T2DM from January 2022 to May 2024. They are categorized based on CHD occurrence into: (1) The control group, consisting of patients with T2DM without CHD; and (2) The observation group, which includes patients with T2MD with CHD. Age, sex, smoking and drinking history, CHD family history, metformin (MET) treatment pre-admission, body mass index, fasting blood glucose (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), serum creatinine, blood urea nitrogen (BUN), alanine aminotransferase, aspartate aminotransferase, glycosylated hemoglobin (HbA1c), and coronary imaging data of both groups were collected from the medical record system. Logistic risk analysis was conducted to screen risk factors. The prediction model’s prediction efficiency was evaluated with receiver operating characteristic curves.

RESULTS

The control and observation groups consisted of 48 and 55 cases, respectively. The two groups were statistically different in terms of age (t = 2.006, P = 0.048), FBG (t = 6.038, P = 0.000), TG (t = 2.015, P = 0.047), LDL-C (t = 2.017, P = 0.046), and BUN (t = 2.035, P = 0.044). The observation group demonstrated lower proportions of patients receiving MET (χ2 = 5.073, P = 0.024) and higher proportions of patients with HbA1c of > 7.0% (χ2 = 6.980, P = 0.008) than the control group. The observation group consisted of 15, 17, and 23 cases of moderate stenosis, severe stenosis, and occlusion, respectively, with a greater number of coronary artery occlusion cases than the control group (χ2 = 6.399, P = 0.041). The observation group consisted significantly higher number of diffuse lesion cases at 35 compared with the control group (χ2 = 15.420, P = 0.000). The observation group demonstrated a higher right coronary artery (RCA) stenosis index (t = 6.730, P = 0.000), circumflex coronary artery (LCX) stenosis index (t = 5.738, P = 0.000), and total stenosis index (t = 7.049, P = 0.000) than the control group. FBG [odds ratio (OR) = 1.472; 95% confidence interval (CI): 1.234-1.755; P = 0.000] and HbA1c (OR = 3.197; 95%CI: 1.149-8.896; P = 0.026) were independent risk factors for T2DM complicated with CHD, whereas MET (OR = 0.350; 95%CI: 0.129-0.952; P = 0.040) was considered a protective factor for CHD in T2DM.

CONCLUSION

Coronary artery occlusion is a prevalent complication in patients with T2DM. Patients with T2MD with CHD demonstrated a higher degree of RCA and LCX stenosis than those with T2DM without CHD. FBG, HbA1c, and MET treatment history are risk factors for T2DM complicated with CHD.

Keywords: Type 2 diabetes mellitus; Coronary heart disease; Coronary imaging; Risk factors; Complication; Risk prediction model

Core Tip: The present study reveals the imaging characteristics of patients with type 2 diabetes mellitus (T2DM) combined with coronary heart disease (CHD). The risk analysis model revealed fasting blood glucose and glycosylated hemoglobin as independent risk factors for T2DM complicated by CHD, and metformin treatment as an independent protective factor. A prediction model for clinical assessment of T2DM complicated with CHD is established, which will promote the development of early diagnosis and risk stratification of T2DM complicated with CHD.