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(Circulation. 1999;99:2239-2242.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Effect of Diabetes Mellitus on Formation of Coronary Collateral Vessels
uzhan, MD
ükrü Ünal, MDFrom the Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
Correspondence to Adnan Abaci, Selanik Cad, Sinema Onay, Kar
isi, Kiliç Apt 29/15, Kayseri-38010, Turkey. E-mail abacia{at}hotmail.com
Background—Although myocardial ischemia is known to be significantly related to the development of coronary collateral vessels (CCVs), there is considerable variation between patients with ischemic heart disease in the presence of collateral development. The nature of this variability is not well known. Likewise, it remains unclear whether diabetes mellitus (DM) has any effect on CCVs. The aim of this study was to evaluate the effect of DM on CCVs.
Methods and Results—Of the patients who underwent
coronary angiography during the interval between March 1, 1993,
and June 20, 1998, in our institution, 306 were diabetic. Those
patients in whom coronary angiography is normal or severity of
coronary artery stenosis is thought not to be
sufficient for the development of CCVs (<75%) were excluded from the
study. A total of 205 patients (mean age, 59±8 years) met the criteria
for the DM group. For case-control matching, 205 consecutive
nondiabetic patients (mean age, 58±9 years) who had 
1 diseased
vessel with >75% stenosis were included in the control group.
The CCVs were graded according to the Rentrop scoring system, and the
collateral score was calculated by summing the Rentrop numbers of every
patient. There was no statistical difference between patients with and
without DM in clinical baseline characteristics. The mean number of
diseased vessels in the DM group (1.58±0.68) was higher than that in
the nondiabetic group (1.42±0.65, P=0.005). The mean
collateral score was 2.41±2.20 in the DM group and 2.60±2.39 in the
control group. After confounding variables were controlled for, the
collateral score in the diabetic group was significantly different from
that in the nondiabetic group (P=0.034).
Conclusions—Our findings suggest that CCV development is poorer in patients with than in patients without DM. Thus, we can speculate that DM is an important factor affecting CCV development.
Key Words: collateral circulation • coronary disease • diabetes mellitus
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 R. T. Hurst and R. W. Lee Increased Incidence of Coronary Atherosclerosis in Type 2 Diabetes Mellitus: Mechanisms and Management Ann Intern Med, November 18, 2003; 139(10): 824 - 834. [Abstract] [Full Text] [PDF]
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M. M. Graham, W. A. Ghali, P. D. Faris, P. D. Galbraith, C. M. Norris, and M. L. Knudtson Sex Differences in the Prognostic Importance of Diabetes in Patients With Ischemic Heart Disease Undergoing Coronary Angiography Diabetes Care, November 1, 2003; 26(11): 3142 - 3147. [Abstract] [Full Text] [PDF]
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R. Tamarat, J.-S. Silvestre, M. Huijberts, J. Benessiano, T. G. Ebrahimian, M. Duriez, M.-P. Wautier, J. L. Wautier, and B. I. Levy Blockade of advanced glycation end-product formation restores ischemia-induced angiogenesis in diabetic mice PNAS, July 8, 2003; 100(14): 8555 - 8560. [Abstract] [Full Text] [PDF]
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G. S. Werner, B. M. Richartz, S. Heinke, M. Ferrari, and H. R. Figulla Impaired acute collateral recruitment as a possible mechanism for increased cardiac adverse events in patients with diabetes mellitus Eur. Heart J., June 2, 2003; 24(12): 1134 - 1142. [Abstract] [Full Text] [PDF]
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N. van Royen, I. Hoefer, M. Bottinger, J. Hua, S. Grundmann, M. Voskuil, C. Bode, W. Schaper, I. Buschmann, and J.J. Piek Local Monocyte Chemoattractant Protein-1 Therapy Increases Collateral Artery Formation in Apolipoprotein E-Deficient Mice but Induces Systemic Monocytic CD11b Expression, Neointimal Formation, and Plaque Progression Circ. Res., February 7, 2003; 92(2): 218 - 225. [Abstract] [Full Text] [PDF]
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K. Hirata, T.-S. Li, M. Nishida, H. Ito, M. Matsuzaki, S. Kasaoka, and K. Hamano Autologous bone marrow cell implantation as therapeutic angiogenesis for ischemic hindlimb in diabetic rat model Am J Physiol Heart Circ Physiol, January 1, 2003; 284(1): H66 - H70. [Abstract] [Full Text] [PDF]
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O. M. Tepper, R. D. Galiano, J. M. Capla, C. Kalka, P. J. Gagne, G. R. Jacobowitz, J. P. Levine, and G. C. Gurtner Human Endothelial Progenitor Cells From Type II Diabetics Exhibit Impaired Proliferation, Adhesion, and Incorporation Into Vascular Structures Circulation, November 26, 2002; 106(22): 2781 - 2786. [Abstract] [Full Text] [PDF]
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F. Facchiano, A. Lentini, V. Fogliano, S. Mancarella, C. Rossi, A. Facchiano, and M. C. Capogrossi Sugar-Induced Modification of Fibroblast Growth Factor 2 Reduces Its Angiogenic Activity in Vivo Am. J. Pathol., August 1, 2002; 161(2): 531 - 541. [Abstract] [Full Text] [PDF]
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E. Chou, I. Suzuma, K. J. Way, D. Opland, A. C. Clermont, K. Naruse, K. Suzuma, N. L. Bowling, C. J. Vlahos, L. P. Aiello, et al. Decreased Cardiac Expression of Vascular Endothelial Growth Factor and Its Receptors in Insulin-Resistant and Diabetic States: A Possible Explanation for Impaired Collateral Formation in Cardiac Tissue Circulation, January 22, 2002; 105(3): 373 - 379. [Abstract] [Full Text] [PDF]
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Z S Kyriakides, S Psychari, N Chrysomallis, M Georgiadis, E Sbarouni, and D T Kremastinos Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during angioplasty Heart, January 1, 2002; 87(1): 61 - 66. [Abstract] [Full Text] [PDF]
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 K. M. Detre and R. Holubkov Coronary Revascularization on Balance: Robert L. Frye Lecture Mayo Clin. Proc., January 1, 2002; 77(1): 72 - 82. [Abstract] [PDF]
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T. Pohl, C. Seiler, M. Billinger, E. Herren, K. Wustmann, H. Mehta, S. Windecker, F. R. Eberli, and B. Meier Frequency distribution of collateral flow and factors influencing collateral channel development: Functional collateral channel measurement in 450 patients with coronary artery disease J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1872 - 1878. [Abstract] [Full Text] [PDF]
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J. L. Tuttle, R. D. Nachreiner, A. S. Bhuller, K. W. Condict, B. A. Connors, B. P. Herring, M. C. Dalsing, and J. L. Unthank Shear level influences resistance artery remodeling: wall dimensions, cell density, and eNOS expression Am J Physiol Heart Circ Physiol, September 1, 2001; 281(3): H1380 - H1389. [Abstract] [Full Text] [PDF]
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R. Moreno, E. Garcia, J. Zamorano, J.-L. Lopez-Sendon, and L. Sanchez-Harguindey Acute myocardial infarcation in diabetic patients. Are we acutally doing bad? Eur. Heart J., August 1, 2001; 22(15): 1359 - 1361. [Abstract] [PDF]
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A. K. M. T. Zaman, S. Fujii, H. Sawa, D. Goto, N. Ishimori, K. Watano, T. Kaneko, T. Furumoto, T. Sugawara, I. Sakuma, et al. Angiotensin-Converting Enzyme Inhibition Attenuates Hypofibrinolysis and Reduces Cardiac Perivascular Fibrosis in Genetically Obese Diabetic Mice Circulation, June 26, 2001; 103(25): 3123 - 3128. [Abstract] [Full Text] [PDF]
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N. van Royen, J. J. Piek, I. Buschmann, I. Hoefer, M. Voskuil, and W. Schaper Stimulation of arteriogenesis; a new concept for the treatment of arterial occlusive disease Cardiovasc Res, February 16, 2001; 49(3): 543 - 553. [Abstract] [Full Text] [PDF]
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J. Waltenberger Impaired collateral vessel development in diabetes: potential cellular mechanisms and therapeutic implications Cardiovasc Res, February 16, 2001; 49(3): 554 - 560. [Abstract] [Full Text] [PDF]
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 T. Melchior, C. Rask-Madsen, C. Torp-Pedersen, P. Hildebrandt, L. Kober, and G. Jensen The impact of heart failure on prognosis of diabetic and non-diabetic patients with myocardial infarction: a 15-year follow-up study Eur J Heart Fail, January 1, 2001; 3(1): 83 - 90. [Abstract] [Full Text] [PDF]
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T. Matsunaga, D. C. Warltier, D. W. Weihrauch, M. Moniz, J. Tessmer, and W. M. Chilian Ischemia-Induced Coronary Collateral Growth Is Dependent on Vascular Endothelial Growth Factor and Nitric Oxide Circulation, December 19, 2000; 102(25): 3098 - 3103. [Abstract] [Full Text] [PDF]
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S. Dimmeler and A. M. Zeiher Endothelial Cell Apoptosis in Angiogenesis and Vessel Regression Circ. Res., September 15, 2000; 87(6): 434 - 439. [Abstract] [Full Text] [PDF]
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T. Hammoud, J.-F. Tanguay, and M. G. Bourassa Management of coronary artery disease: therapeutic options in patients with diabetes J. Am. Coll. Cardiol., August 1, 2000; 36(2): 355 - 365. [Abstract] [Full Text] [PDF]
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J. Waltenberger, J. Lange, and A. Kranz Vascular Endothelial Growth Factor-A-Induced Chemotaxis of Monocytes Is Attenuated in Patients With Diabetes Mellitus : A Potential Predictor for the Individual Capacity to Develop Collaterals Circulation, July 11, 2000; 102(2): 185 - 190. [Abstract] [Full Text] [PDF]
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T. O'Brien Adenoviral Vectors and Gene Transfer to the Blood Vessel Wall Arterioscler Thromb Vasc Biol, June 1, 2000; 20(6): 1414 - 1416. [Full Text] [PDF]
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 K. M. Detre, M. S. Lombardero, M. M. Brooks, R. M. Hardison, R. Holubkov, G. Sopko, R. L. Frye, B. R. Chaitman, and The Bypass Angioplasty Revascularization Investiga The Effect of Previous Coronary-Artery Bypass Surgery on the Prognosis of Patients with Diabetes Who Have Acute Myocardial Infarction N. Engl. J. Med., April 6, 2000; 342(14): 989 - 997. [Abstract] [Full Text] [PDF]
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W. Schaper and I. Buschmann Collateral Circulation and Diabetes Circulation, May 4, 1999; 99(17): 2224 - 2226. [Full Text] [PDF]
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