Abstract
Background: Coronary artery disease (CAD) remains one of the leading causes of mortality and disease burden globally as well as in Vietnam. Among cardiovascular risk factors, type 2 diabetes mellitus (T2DM) is considered a “silent killer” that significantly increases the risk of developing coronary artery pathology. Chronic hyperglycemia, insulin resistance, and dyslipidemia accelerate the atherosclerotic process, leading to complex, diffuse, and severely calcified coronary artery lesions which poses substantial challenges for clinical percutaneous coronary intervention (PCI) strategies. Objectives: 1. To investigate the morphological characteristics of coronary artery lesions on percutaneous coronary angiography in patients with T2DM at Viet Tiep Friendship Hospital during 2024-2025. 2. To evaluate the characteristics of stent implantation and their relationship with the complexity of lesions in the study population. Patients and Methods: A cross-sectional descriptive study with prospective longitudinal follow-up was conducted on patients diagnosed with T2DM who had indications for percutaneous coronary angiography and intervention at the Department of Cardiac and Vascular Interventions, Viet Tiep Friendship Hospital, from January 2024 to December 2025. The severity of anatomical lesions (stenosis location, number of affected vessels, diffuse nature, and calcification) was evaluated by visual estimation using standard DSA angiographic views. Interventional characteristics, including the number of stents, stent length, stent diameter, and the use of conventional angioplasty balloons, were recorded from the technical labels in the medical records. Results: Lesion characteristics: Patients with T2DM predominantly exhibited multi-vessel disease, with a significantly higher mean number of involved coronary branches compared to the non-diabetic group (2.09 ± 0.89 vs. 1.98 ± 0.86 vessels, P = 0.04). The left anterior descending (LAD) artery was the most common site of lesion, with T2DM increasing the risk of lesion in this branch by 1.55 times (P < 0.01). The rates of lesions with complex characteristics, such as severe calcification and vessel tortuosity, were markedly higher in the T2DM group compared to the control group (P < 0.01). Interventional characteristics: Due to the complex nature of the lesions, the mean number of stents deployed per patient in the T2DM group was significantly higher than in the non-diabetic group (1.18 ± 0.53 vs. 1.07 ± 0.39 stents/patient, P = 0.01). The average stent length used in the T2DM group was 27.22 ± 14.51 mm. Conclusions: Coronary artery lesions in patients with type 2 diabetes mellitus are severe, diffuse, and multi-vessel in nature. The intervention process requires complex strategies involving a greater number of stents. Active early screening for coronary complications is essential to improve the long-term prognosis for this patient population.
