Inverse association between diabetes and aortic dilatation in patients with advanced coronary artery disease

Background: A negative association between diabetes and abdominal aortic aneurysm has recently been reported. The purpose of this study was to assess the relationship between diabetes and aortic diameter, including non-aneurysmal aortic diameter, in patients with advanced coronary artery disease. Methods: We identified 351 consecutive patients who had undergone coronary artery bypass graft surgery. The patients were divided into two groups: those with diabetes mellitus (DM) (DM+ group; n=180), and those without DM (DM- group; n=171). Infrarenal and ascending aortic diameters were measured by preoperative computed tomography and corrected for body surface area. Results: Infrarenal and ascending aortic diameters were significantly shorter in the DM+ group than in the DM- group (21.3±5.0mm vs. 24.7±9.8mm, p<0.001 and 36.0±4.4mm vs. 37.8±5.5mm, p=0.001, respectively). The rates of infrarenal aortic diameter ≥30mm and ascending aortic diameter ≥40mm were significantly lower in the DM+ group than in the DM- group (3.5% vs. 13.3%, p=0.003 and 14.2% vs. 24.1%, p=0.025, respectively). Multivariate models demonstrated diabetes to be an independent predictor of both infrarenal and ascending aortic diameters even after correction for body surface area. Conclusion: Our findings indicated an inverse association between diabetes and aortic dilatation of both the infrarenal and ascending aorta in patients with advanced coronary artery disease.