Possible Predictors of Coronary Heart Disease in Patients with Type 2 Diabetes Mellitus

Diabetes mellitus (DM) is a disease that is often associated with coronary heart disease. However, it is not known when coronary heart disease (CHD) will occur in these patients and what other possible predictors of its occurrence are. The aim of this study was to determine possible predictors of the development of CHD in patients with type 2 diabetes mellitus (T2DM). The study included 137 patients in the period from July 2020 to September 2021, examined in the internal medicine ambulance at the University clinical center of Serbia. The patients were divided into three groups: healthy control group (35 patients), patients with T2DM without known CHD (38 patients) and patients with T2DM and CHD (64 patients). We observed the influence of age, gender, body weight, body mass index (BMI), obesity, duration of T2DM, applied therapy, laboratory analyzes as well as echocardiographic parameters on the occurrence of CHD. Combined risk factors for obesity, hypertension and hyperlipidemia are more common in diabetics compared to the healthy population, especially in diabetics with CHD (p = 0.001, p < 0.001, p = 0.002, consecutive), but did not have a significant effect on the course of T2DM and the development of CHD (p = NS). Therapy with sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) and metformin was more commonly used in T2DM without CHD (p = 0.002, p = 0.001, consecutive). All parameters of systolic and diastolic function of LV were pathological in T2DM, especially in CHD. Function of right ventricle (RV) was a less significant indicator of a worse T2DM prognosis, and only tricuspid annular plane systolic excursion (TAPSE) showed statistical significance (P < 0.001). Obesity, hypertension and hyperlipidemia as risk factors did not have a significant impact on T2DM flow and CHD development. Modern T2DM therapy and shorter duration of the disease prevented a worse prognosis for the patients. Systolic and diastolic functions parameters of left ventricle (LV), but not all the parameters of the RV function, indicated the development of CHD in T2DM.