CONGRESS ABSTRACT

Diabetes mellitus increases the risk of atherosclerotic cardiovascular disease (ASCVD). Diabetic patients often present with diffuse, calcified, and multivessel disease, complicating diagnosis and revascularization strategies. Critical stenoses of the left anterior descending (LAD) artery and left main coronary artery (LM) are associated with poor prognosis. Peripheral arterial disease (PAD), including involvement of iliac-femoral and carotid arteries, is also common and contributes to limb ischemia and cerebrovascular risk. However, contemporary data on the combined coronary and peripheral angiographic burden in cardiodiabetology outpatient populations are limited. A retrospective study was conducted involving 60 consecutive patients with type 2 diabetes mellitus attending a cardiodiabetology outpatient clinic, who underwent diagnostic coronary and/or peripheral angiography between May 2024 and December 2025. Demographic data, CV risk factors, angiographic findings, and treatment strategies were collected from electronic medical records. Critical coronary stenosis was defined as ≥70% luminal narrowing (≥50% for LM), while critical peripheral stenosis was defined as ≥70% narrowing of iliac-femoral or carotid arteries. Multivessel coronary disease was defined as involvement of ≥2 major coronary territories. Results The mean age of patients was 65 years (±9), and 70% were male. Hypertension was present in 75%, dyslipidemia in 68%, smoking history in 35%, and the average duration of diabetes was 10 years (±5). Critical LAD stenosis was found in 30 patients (50%), while LM disease was present in 6 patients (10%), half of whom were referred for coronary artery bypass grafting (CABG). Multivessel coronary disease was identified in 27 patients (45%). Critical PAD was found in 15 patients (25%), with involvement of iliac-femoral arteries in 7 and carotid arteries in 8. Most isolated coronary and peripheral lesions were treated percutaneously, while surgical referral was reserved for complex multivessel and LM disease cases. Notably, 20% of patients with multivessel coronary disease also had critical peripheral lesions. Conclusions In this high-risk cohort, critical coronary and PAD was highly prevalent, with frequent multivessel involvement reflecting advanced systemic atherosclerosis. An integrated coronary and peripheral assessment, along with individualized revascularization strategies, is essential to optimize management and outcomes in patients with diabetes.