Studies of the characteristics of coronary artery disease (CAD) in diabetic patients
have shown conflicting results. Only 2 studies exploring the severity of CAD, specifically
in type 1 diabetes, have been published, and neither of them has used computer-aided
quantitative coronary angiography. This retrospective study comprised 64 (24 women
and 40 men) type 1 diabetic patients and nondiabetic control subjects. To estimate
the severity, extent, and overall "atheroma burden" of CAD, we used quantitative coronary
angiographic-based segmental analysis of coronary angiograms. Type 1 diabetic patients
had greater global severity (p < 0.001), global extent (p < 0.001), and global atheroma
burden (p < 0.001) indexes than nondiabetic control subjects. Quantitative coronary
angiographic-derived indexes of CAD were, on average, 1.4- to 4.3-fold higher in diabetic
than in nondiabetic patients. These differences were particularly marked in women.
We found that type 1 diabetic patients with a clinical indication for coronary angiography,
especially women, have more severe, extensive, and distal type of CAD than individually
matched nondiabetic control patients. Our findings, including a loss of sex difference
for CAD among type 1 diabetic patients and a marked impact of type 1 diabetes in women,
are not explained by established risk factors.