O.O. Kutsyn.Comorbidity of ischemic heart disease and type 2 diabetes mellitus in residents of different altitude regions of Transcarpathia

The aim – to study coronary circulation and features of ischemic heart disease with and without concomitant diabetes mellitus (DM) among residents of mountain and lowland settlements of Transcarpathia.
Material and methods. The study involved 111 patients with ischemic heart disease who were divided into 2 groups: I group – patients without DM – 59 (53.2 %) persons; group II – patients with verified diagnosis of DM – 52 (46.8 %) patients. All patients underwent an electrocardiogram, echocardiogram, general clinical laboratory tests, exercise stress test or Holter ECG monitoring.
Results. In 66.7 % of patients with DM from mountain settlements lesions of three coronary arteries (CA) were identified, 33.3 % persons had lesions of one or two CA; among the inhabitants of the plains settlements, in contrast, dominated stenosis of 1 or 2 CA (66.7 %), whereas lesions of 3 arteries were observed only in 16.7 % (Р<0.01); lesions of three or more segments of CA were identified 6 times more often among mountaineers – 66.7 % versus 11.1 % in the lowland population (Р=0.018). Lesions of the right coronary artery (RCA) were observed in almost all highlanders with DM (33.3 % had stenosis, 66.7 % had occlusion of RCA), among the plains inhabitants RCA stenosis was diagnosed only in 55.5 % (occlusion happened 12 times less – at 5.6 %, Р<0.01). At the same time, significant differences in lesion of left anterior descending artery and circumflex branch of the left coronary artery have not been found in these patient populations. Conclusions. At least half of men and women older than 50 years with ischemic heart disease and DM have multivessel CA lesion regardless of height above sea level. Residents of mountain settlements with ischemic heart disease and DM have worse condition of coronary artery compared with residents of lowland settlements: they have significantly more common multivessel and multisegment CA lesions and almost always they have lesion of RCA.

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