Abstract

Objective
To perform a comparative assessment of atherosclerotic coronary artery lesions based on coronary angiography (CAG) and to analyze the causes of rehospitalizations in patients with ischemic heart disease (IHD), depending on the presence of concomitant type 2 diabetes mellitus (T2DM).
Materials and Methods
A prospective comparative study included 58 patients with IHD without prior myocardial infarction or revascularization who underwent CAG. Patients were divided into two groups: Group I – IHD with T2DM (n=22), Group II – IHD without T2DM (n=36). Demographic parameters, symptoms, pre-test probability of IHD, angiographic characteristics (extent, type and severity of lesions, calcification), as well as causes of rehospitalizations within 30 and 365 days after discharge were evaluated.
Results
A prospective comparative study included 58 patients with IHD without prior myocardial infarction or revascularization who underwent CAG. Patients were divided into two groups: Group I – IHD with T2DM (n=22), Group II – IHD without T2DM (n=36). Demographic parameters, symptoms, pre-test probability of IHD, angiographic characteristics (extent, type and severity of lesions, calcification), as well as causes of rehospitalizations within 30 and 365 days after discharge were evaluated.
Conclusion
Patients with IHD and concomitant T2DM demonstrate more severe, extensive, and calcified coronary artery lesions. The presence of T2DM is associated with a statistically significant higher risk of rehospitalizations within one year, predominantly for cardiovascular causes, which requires a comprehensive management approach for this patient category.

Keywords

ischemic heart disease (IHD) type 2 diabetes mellitus (T2DM) coronary angiography (CAG) atherosclerosis rehospitalizations

Full Text

Download article (PDF)

Full version of the article in PDF format

References

  1. 1. Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators. Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990–2023. *J Am Coll Cardiol*. 2025;86(22):2167–2243. doi:10.1016/j.jacc.2025.08.015.
  2. 2. Zareini B, Blanche P, D’Souza M, Elmegaard Malik M, Nørgaard CH, Selmer C, et al. Type 2 Diabetes Mellitus and Impact of Heart Failure on Prognosis Compared to Other Cardiovascular Diseases: A Nationwide Study. *Circ Cardiovasc Qual Outcomes*. 2020;13(7):386–394. doi:10.1161/CIRCOUTCOMES.119.006260.
  3. 3. Файзуллоев АИ, Шукурова СМ, Рашидов ИМ, Раджабова ГМ. Хроническая сердечная недостаточность: современные проблемы и пути их решения. *Вестник последипломного образования в сфере здравоохранения*. 2021;(2):93–100.
  4. 4. Karakasis P, Theofilis P, Patoulias D, Vlachakis PK, Antoniadis AP, Fragakis N. Diabetes-Driven Atherosclerosis: Updated Mechanistic Insights and Novel Therapeutic Strategies. *Int J Mol Sci*. 2025;26(5):2196. doi:10.3390/ijms26052196.
  5. 5. Gaillard EL, Cramer SHM, Hanssen NMJ, Bom MJ, Chamuleau SAJ, Planken RN, et al. Increased High-Risk Plaque Burden in Type 2 Diabetes: A 10-Year Follow-Up Study. *Cardiovasc Diabetol*. 2025;24(1):423. doi:10.1186/s12933-025-02977-1.
  6. 6. Kunadian V, Chieffo A, Camici PG, Berry C, Escaned J, Maas AHEM, et al. An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group. *EuroIntervention*. 2021;16(13):1049–1069. doi:10.4244/EIJY20M07_01.
  7. 7. Mehta PK, Huang J, Levit RD, Malas W, Waheed N, Bairey Merz CN. Ischemia and No Obstructive Coronary Arteries (INOCA): A Narrative Review. *Atherosclerosis*. 2022;363:8–21. doi:10.1016/j.atherosclerosis.2022.11.009.
  8. 8. Козиолова НА, Полянская ЕА, Миронова СВ. Сахарный диабет 2 типа и микрососудистые осложнения у больных стабильной ишемической болезнью сердца: распространенность, прогноз и выбор антитромботической терапии. *Южно-Российский журнал терапевтической практики*. 2022;3(4):7–24. doi:10.21886/2712-8156-2022-3-4-7-24.
  9. 9. Марданов БУ, Мосолова ЕС. Структурно-функциональные особенности миокарда у больных ишемической болезнью сердца и сахарным диабетом 2 типа. *Международный журнал сердца и сосудистых заболеваний*. 2021;9(32):20–26. doi:10.24412/2311-1623-2021-32-20-26.
  10. 10. Yin J, Fu X, Luo Y, Leng Y, Ao L, Xie C. A Narrative Review of Diabetic Macroangiopathy: From Molecular Mechanism to Therapeutic Approaches. *Diabetes Ther*. 2024;15(3):585–609. doi:10.1007/s13300-024-01532-7.
  11. 11. Jiang Y, Yang ZG, Wang J, Jiang L, Han PL, Shi R, et al. Type 2 Diabetes Mellitus Aggravates Coronary Atherosclerosis in Hypertensive Individuals Based on Coronary CT Angiography: A Retrospective Propensity Score-Based Study. *Front Cardiovasc Med*. 2024;11:1372519. doi:10.3389/fcvm.2024.1372519.
  12. 12. Parvez M, Habib M, Ali A, Naila B, Khattak NUS, Wahab M, et al. Impact of Diabetes on Coronary Angiographic Findings in ST-Elevation Myocardial Infarction Patients: A Comparative Study. *Cureus*. 2025;17(9):e91675. doi:10.7759/cureus.91675.
  13. 13. Valensi P, Berkane N, Pinto S, Sellier N, Soussan M, Nguyen MT, et al. Performance of the 2019 ESC/EASD Guideline Strategy for the Screening of Silent Coronary Artery Disease in Patients with Diabetes. *Cardiovasc Diabetol*. 2023;22(1):33. doi:10.1186/s12933-023-01760-4.
  14. 14. Al-Jarallah M, Rajan R, Al-Zakwani I, Dashti R, Bulbanat B, Ridha M, et al. Impact of Diabetes on Mortality and Rehospitalization in Acute Heart Failure Patients Stratified by Ejection Fraction. *ESC Heart Fail*. 2020;7(1):297–305. doi:10.1002/ehf2.12538.