Comparison of coronary collateral circulation in diabetic and nondiabetic patients suffering from coronary artery disease

Comparison of coronary collateral circulation in diabetic and nondiabetic patients suffering from coronary artery disease

Background and hypothesis: Although it is well established that diabetes mellitus (DM) induces more severe coronary artery disease (CAD), it is not known whether it contributes to the development of coronary collateral circulation. The present study examines coronary collateral circulation in diabet...

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Bibliographic Details
Published in:Clinical cardiology (Mahwah, N.J.) Vol. 22; no. 7; pp. 465 - 471
Main Authors: Melidonis, A., Tournis, S., Kouvaras, G., Baltaretsou, E., Hadanis, S., Hajissavas, I., Tsatsoulis, A., Foussas, S.
Format: Journal Article
Language:English
Published: New York Wiley Periodicals, Inc 01-07-1999
Wiley
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cardiology. Vascular system
Clinical Investigation
Clinical Investigations
Collateral Circulation
coronary artery disease
Coronary Circulation
coronary collateral circulation
Coronary Disease - complications
Coronary Disease - physiopathology
Coronary heart disease
Diabetes Complications
diabetes mellitus
Diabetes Mellitus - physiopathology
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Prospective Studies
Risk Factors
Endocrinopathy
Human
Collateral circulation
Concomitant disease
Pathophysiology
Diabetes mellitus
Cardiovascular disease
Coronary vessel
Coronary heart disease
Comparative study
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Summary:Background and hypothesis: Although it is well established that diabetes mellitus (DM) induces more severe coronary artery disease (CAD), it is not known whether it contributes to the development of coronary collateral circulation. The present study examines coronary collateral circulation in diabetic and nondiabetic patients with angiographically verified CAD. Methods: The study group consisted of 463 diabetic patients (382 men, 81 women) with a mean age of 60.3 ± 8.8 years, and 227 nondiabetic subjects (159 men, 68 women) with a mean age of 59.2 ± 9 years. The extension and functional capacity of coronary collateral circulation was assessed according to the Cohen and Rentrop grading system of 0 to III. Results: We found that diabetic patients had grade III collateral circulation more frequently than nondiabetic subjects (13.2 vs. 8.5%, p<0.01). This finding was even more pronounced in diabetic men aged < 55 years compared with both nondiabetic men (20 vs. 3.4%, p<0.001) and diabetic women (20 vs. 2.2%, p<0.001). Grade III collateral circulation was found to develop mainly at the left anterior descending (LAD) coronary artery and the right coronary artery (RCA), where complete occlusions of coronary arteries usually occur. Conclusions: Diabetic patients with CAD develop more extensive coronary collateral circulation than nondiabetic subjects, especially men aged <55 years. The collateral circulation mainly develops at the LAD and RCA.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0160-9289
1932-8737
DOI:10.1002/clc.4960220706