Impact of diabetes mellitus on other cardiovascular risk factors in patients with stenosis of the internal carotid artery

Aim. To examine cardiovascular risk factors, clinical features and their impact on the results of carotid endarterectomy in diabetic patients with stenosis of the internal carotid artery. Material and methods. We analysed data on 100 diabetic and 607 nondiabetic patients who underwent carotid endarterectomy in Vilnius University Emergency hospital from 1995 through 2005. Results. Diabetic patients with carotid artery stenosis were younger (p < 0.05), they smoked less often (p < 0.001) and were more often obese (p < 0.001) than nondiabetic patients. 93% of diabetic patients had arterial hypertension or hypercholesterolemia or even more cardiovascular risk factors. Diabetic were more likely to have nonspecific symptoms and severe bilateral carotid stenosis (p < 0.01). Perioperative stroke and mortality rate was 12% for diabetic and 3.4% for nondiabetic patients (p < 0.001), but no perioperative myocardial infarction was identified in diabetic patients. Four clinical-factors increased the odds of complications: age 75 > (odds ratio - OR 2.2, 95% confidence interval - CI 1-4.9), smoking (OR 2.7, 95% CI 1.8-4.2), obesity (OR 6 1; 95% CI 3.9-9.5) and severe bilateral carotid stenosis (OR 2.1; 95% CI 1.3-3.6). Conclusion. Diabetes mellitus in patients with severe carotid artery stenosis changes conventional risk factors, clinical picture of the disease and increases the risk of carotid endarterectomy.