Exercise Testing, Clinical, and Angiographic Characteristics of Anginal Patients With and Without Diabetes Mellitus

Abstract

To elucidate the influence of coex isting diabetes mellitus (DM) on clini cal and pathophysiologic characteris tics in patients with coronary artery disease (CAD), the authors reviewed 1,211 consecutive patients who un derwent coronary angiography (CAG) and selected 80 patients with significant CAD but without myocar dial infarction, hypertension, or other heart diseases, who underwent both symptom-limited treadmill test (TM) and CAG within four weeks. DM was found in 22 of the 80 pa tients. No significant difference in the average number of diseased arteries or left ventricular ejection fraction at rest was found between DM patients and patients without DM (NDM pa tients). The incidences of exercise-in duced ST depression and anginal pain revealed no difference between DM and NDM patients. Mean dura tion of exercise was shorter in DM patients (345±97 sec) than in NDM patients (423±162 sec, p<0.01). Furthermore, anginal pain during exercise occurred earlier in DM pa tients (187±68 sec) than in NDM pa tients (248±99 sec, p<0.05). No significant difference in double prod uct or magnitude of ST segment de pression at the onset of anginal pain was found between DM and NDM patients. However, heart rate respon siveness to exercise in DM patients was higher than that in NDM pa tients. These findings may indicate that pathophysiology of the heart in CAD patients with DM is affected not only by CAD itself but also by myocardial damage due to DM.