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Cardiomyopathic syndrome due to coronary arter disease. II: Increased prevalence in patients with diabetes mellitus: a matched pair analysis.

To test the hypothesis that the prevalence of a cardiomyopathic syndrome in association with coronary artery disease is higher among diabetic patients, clinical, ventriculographic, and arteriographic features of coronary artery disease were evaluated in 84 patients with coronary artery disease. Forty-two diabetics were compared with 42 non-diabetics who were randomly selected and matched for age, sex, blood pressure, and serum lipids. The diabetic group represented all diabetic patients with angiographic coronary artery disease identified over a 6-year period who could be matched for these variables. The coronary circulation was divided into 6 arterial segments, and arteriograms were assigned a jeopardy score that expresses the number of segments jeopardised by signmficant proximal stenoses. Distal coronary artery disease was scored separately. The cardiomyopathic syndrome due to coronary artery disease was defined by evidence of chronic heart failure in association with significant reduction of the left ventricular ejection fraction ( <.048) caused by multiple and widespread left ventricular wall motion abnormalities. There was an increased prevalence of the syndrome in the diabetic group compared with the control group (20 patients vs 10 patients, P<0 05) and this was reflected in a lower mean ejection fraction in the diabetic group as a whole (0-47vs 0 56, P<005). There was also a higher prevalence ofmultiple myocardialinfarcts (21 diabetics vs 9 controls with .2 myocardial infarctions, P<0 05) and anterior myocardial infarcts (23 diabetics vs 13 controls, P<0 05) in the diabetic group. There were no differences between the two groups in the prevalence of stable or unstable angina, persistent arrhythmias,