Prognostic signs of an unfavorable course of coronary heart disease in patients with type 2 diabetes mellitus

Main Article Content

Yu.M. Urmanova
Sh.Sh. Mukhtarova
A.B. Grossman
M.Z. Mukhtarova
R.Kh. Trigulova


Background. Despite the successful development of medical technologies in the diagnosis of coronary heart disease, mortality due to cardiovascular diseases in the population of patients with diabetes mellitus (DM) is not reduced. The development of an algorithm for the early diagnosis of coronary heart di­sease and ways to correct it is a topical problem of cardiology and endocrinology. The purpose is to determine prognostic signs for an unfavorable course of coronary heart disease and develop a table of test probabilities in order to enhance the effectiveness of risk stratification in patients with type 2 DM. Materials and methods. During 2017–2019, there were observed 40 patients (16 men and 24 women) with type 2 DM in combination with coronary heart disease. We took into account the presence of acute myocardial infarction, acute cerebrovascular accidents (stroke), repeated surgical interventions (percutaneous coronary intervention, coronary artery bypass grafting) for the last 3 years. The average age of patients was 65.5 years. Results. In total, 119 signs recorded in the first three days from the moment of patient’s admission were analyzed as possible predictors of an unfavorable prognosis. As markers of coronary heart disease, parameters were adopted that showed the highest occurrence in the group of patients with adverse course of DM and coronary heart disease. The most patho­gnomonic predictors of coronary heart disease progression in patients with type 2 DM were left ventricular systolic dysfunction (ejection fraction < 40 %), systolic blood pressure > 160 mmHg or diastolic blood pressure above 100 mmHg, electrocardiographic signs of myocardial ischemia, persisting upon discharge from the hospital. Conclusions. Criteria that negatively affect the long-term outcome of coronary heart disease in patients with type 2 diabetes are decompensation of DM, in particular, a high level of fasting glycemia (> 13 mmol/l), as well as an increase in total cholesterol and low-density lipoprotein cholesterol.

Article Details

How to Cite
Urmanova, Y., S. Mukhtarova, A. Grossman, M. Mukhtarova, and R. Trigulova. “Prognostic Signs of an Unfavorable Course of Coronary Heart Disease in Patients With Type 2 Diabetes Mellitus”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 2, Mar. 2020, pp. 98-103, doi:10.22141/2224-0721.16.2.2020.201293.
Original Researches


Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246–1258. doi:10.4239/wjd.v6.i13.1246.

Matheus AS, Tannus LR, Cobas RA, Palma CC, Negrato CA, Gomes MB. Impact of diabetes on cardiovascular disease: an update. Int J Hypertens. 2013;2013:653789. doi:10.1155/2013/653789.

Rosano GM, Vitale C, Seferovic P. Heart Failure in Patients with Diabetes Mellitus. Card Fail Rev. 2017;3(1):52–55. doi:10.15420/cfr.2016:20:2.

Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17(1):83. doi:10.1186/s12933-018-0728-6.

Cavender MA, Steg PG, Smith SC Jr, et al. Impact of Diabetes Mellitus on Hospitalization for Heart Failure, Cardiovascular Events, and Death: Outcomes at 4 Years From the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Circulation. 2015;132(10):923–931. doi:10.1161/CIRCULATIONAHA.114.014796.

Dei Cas A, Khan SS, Butler J, et al. Impact of diabetes on epidemiology, treatment, and outcomes of patients with heart failure. JACC Heart Fail. 2015;3(2):136–145. doi:10.1016/j.jchf.2014.08.004.

Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Circulation. 2014;129(25 Suppl 2):S49–S73. doi:10.1161/01.cir.0000437741.48606.98.

Kengne AP, Batty GD, Hamer M, Stamatakis E, Czernichow S. Association of C-reactive protein with cardiovascular disease mortality according to diabetes status: pooled analyses of 25,979 participants from four U.K. prospective cohort studies. Diabetes Care. 2012;35(2):396–403. doi:10.2337/dc11-1588.

Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255–323. doi:10.1093/eurheartj/ehz486.

Rana JS, Liu JY, Moffet HH, Jaffe M, Karter AJ. Diabetes and Prior Coronary Heart Disease are Not Necessarily Risk Equivalent for Future Coronary Heart Disease Events. J Gen Intern Med. 2016;31(4):387–393. doi:10.1007/s11606-015-3556-3.

Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889–2934. doi:10.1016/j.jacc.2013.11.002.

Akazawa S, Tojikubo M, Nakano Y, et al. Usefulness of carotid plaque (sum and maximum of plaque thickness) in combination with intima-media thickness for the detection of coronary artery disease in asymptomatic patients with diabetes. J Diabetes Investig. 2016;7(3):396–403. doi:10.1111/jdi.12403.

Scirica BM, Bhatt DL, Braunwald E, et al. Prognostic Implications of Biomarker Assessments in Patients With Type 2 Diabetes at High Cardiovascular Risk: A Secondary Analysis of a Randomized Clinical Trial. JAMA Cardiol. 2016;1(9):989–998. doi:10.1001/jamacardio.2016.3030.

Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA. 2015;314(10):1021–1029. doi:10.1001/jama.2015.10029.

Wang L, Gao P, Zhang M, et al. Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013. JAMA. 2017;317(24):2515–2523. doi:10.1001/jama.2017.7596.

Rawshani A, Rawshani A, Franzén S, et al. Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes. N Engl J Med. 2017;376(15):1407–1418. doi:10.1056/NEJMoa1608664.

Avogaro A, Giorda C, Maggini M, et al. Incidence of coronary heart disease in type 2 diabetic men and women: impact of microvascular complications, treatment, and geographic location. Diabetes Care. 2007;30(5):1241–1247. doi:10.2337/dc06-2558.

Stefan N, Staiger H, Wagner R, et al. A high-risk phenotype associates with reduced improvement in glycaemia during a lifestyle intervention in prediabetes. Diabetologia. 2015;58(12):2877–2884. doi:10.1007/s00125-015-3760-z.

Most read articles by the same author(s)

1 2 3 4 > >>