Session Information
Date: Monday, June 20, 2016
Session Title: Parkinsonism, MSA, PSP (secondary and parkinsonism-plus)
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate clinical outcomes in patients with parkinsonism syndrome with/without type 2 diabetes (T2DM) 1-year after operation due to lower extremity artery disease (LEAD) .
Methods: In the year 2013 we operated 82 consecutive patients (mean age 58.3±7.8 years) with parkinsonism syndrome and LEAD, 44 of them without diabetes (control), 38 patients with T2DM (main group). All the patients underwent lower extremity and coronary artery computed tomography (CT) using a 64 detector rows CT scanner GE USA VCT cardiac 72013287YA2008, coronary angiography. Laboratory tests, ECG, echocardiography were made before operation and every month during 1-year examination period.
Results: Patients in both groups during study were not strict compliant with prescribed treatment (double antiplatelet therapy, statins, antihypertensive drugs et al.) T2DM patients had elevated HbA1c after admission to the Centre, we detected significant decrease the level in 1-year examination period (11.2±1.3% to 9.1±0.6%, p=0.001) on individual insulin therapy.More severe lipid disorders before operation and in 1-year examination were observed in T2DM patients then in controls; total cholesterol was 10.8±1.2 vs. 8.2±0.6 at 1st day and 7.2±1.2 vs. 6.1±1.1 mmol/l in 1-year (p=0.001). LDL-C was 6.3±1.4 vs. 6.1±1.4 mmol/l, and decreased in both groups during study to 4.11±0.8 vs. 4.13.±1.5 mmol/l; p=0.001. Triglycerides were higher in T2DM patients 8.3±0.9 vs. 6.3±0.8 mmil/l (p=0.001), and decreased to 6.35±0.73 vs. 5.11±0.52 mmol/l (p=0.001), respectively. Coronary artery disease (CAD) was detected by coronary computed tomographic angiography (CCTA) during 1st admission to the Centre. Only 6/38 patients with T2DM on CCTA (15.7%) had non-obstructive CAD (stenosis<50%) vs. 24 patients (54.5%) in control group. 1-/2-/3-vessels obstructive CAD was more often in T2DM group 14(36.8%)/9(23.7%)/9(23.7%) vs. 11(25%)/7(15.9%)/2(4.5%) without diabetes patients (p<0.0001). More severe obstructive coronary lesions had more severe cardiovascular outcomes. We evaluated increase in 1-year postoperative mortality rate in patients with T2DM.
| Clinical outcomes | No diabetes n=44(%) | With diabetes n=38(%) | p-value |
| 1-year postoperative mortality | 2(4.6) | 10(26.3) | 0.0098 |
| Myocardial infarction | 3(6.9) | 9(23.7) | 0.0570 |
| Fatal myocardial infarction | 1(2.3) | 5(13.2) | 0.0911 |
| Ischemic stroke/fatal | 1(2.3)/- | 2(5.2)/ 2(5.2) | 0.5941 |
| Fatal pulmonary embolism | – | 3(7.9) | 0.0953 |
| Gastrointestinal bleeding | 1(2.3) | 1(2.6) | 1.0 |
| Clinical outcomes | No diabetes n=44(%) | With diabetes n=38(%) | p-value |
| Balloon angioplasty of lower limb artery(s) | 9(22.1) | 14(23.5) | 0.1394 |
| Amputation of 1-2 toes | 4(2.6) | 11(15.7) | 0.0442 |
| Partial foot amputation | 1(1.3) | 7(9.8) | 0.0219 |
| Metatarsal amputation | 2(2.6) | 3(6.9) | 0.6588 |
| Trans-femoral amputation | 1(1.3) | 4(2.9) | 0.1772 |
Conclusions: Patients with parkinsonism syndrome and T2DM have 5fold increase risk in incidence of death and 3fold increase risk of myocardial infarction. LEAD progression was more severe in diabetic patients.
To cite this abstract in AMA style:
E. Shalaeva, B. Janabaev, Q. Matmurotov, U. Kasimov, U. Pulatov, A. Bobabekov, M. Bozorboev. 1-year clinical outcomes in patients with parkinsonism syndrome with/without type 2 diabetes [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/1-year-clinical-outcomes-in-patients-with-parkinsonism-syndrome-withwithout-type-2-diabetes/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/1-year-clinical-outcomes-in-patients-with-parkinsonism-syndrome-withwithout-type-2-diabetes/