Diabetes mellitus and female gender are the strongest predictors of poor collateral vessel development in patients with severe coronary artery stenosis

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• 作者：Ertan Yetkin ; Ergun Topal ; Nuri Erguzel ; Kubilay Senen ; Gulumser Heper…
• 关键词：Arteriogenesis ; Diabetes mellitus ; Collateral vessel ; Gender
• 刊名：Angiogenesis
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：18
• 期：2
• 页码：201-207
• 全文大小：263 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Cancer Research
  Cell Biology
  Cardiology
  Ophthalmology
  
• 出版者：Springer Netherlands
• ISSN：1573-7209

文摘

Background Coronary collateral vessel development (CVD), i.e., arteriogenesis, is regarded as one of the most important mechanisms—along with angiogenesis—to result in protection of the myocardium. Coronary CVD is associated with a reduction in infarct size, future cardiovascular events and improved survival in patients with occlusive coronary artery disease by enhancing regional perfusion in the chronically ischemic myocardium. In the present study, we aimed to investigate the relation of cardiovascular risk factors and hematological parameters with collateral development in patients with severely stenotic (?5?%) and totally occluded coronary artery disease including at least one major coronary artery. Materials and methods The study population was selected from the patients who underwent coronary angiography between January 2008 and March 2009. Five hundred and two patients who had at least one coronary artery stenosis ?5?% (368 men; mean age 59?±?10?years) comprised the study population. Of the 502 patients, 228 had total occlusion in at least one major epicardial coronary artery. Collateral artery grading was performed by using Cohen–Rentrop method to the vessel with coronary artery stenosis of ?5?% and patients with chronic total occlusions (CTO). Patients with grade 0- collateral development were regarded as the poor collateral group, and patients with grade 2- collateral development were regarded as the good collateral group. Results Two hundred and fifty-eight (51?%) of 502 patients had poor collateral development, and 244 (49?%) had good collateral development. Logistic regression analysis revealed that DM was independently associated with poor CVD in patients with ?5?% stenosis (p?p?=?0.005 and p?Monocyte count was found to be independent of CVD neither in patients with ?5?% stenosis nor in patients with CTO. Conclusion Our data show that DM is an independent factor for poor coronary CVD both in patients with severe coronary artery stenosis and in patients with CTO. Female gender or being in post-menopausal period is another negative risk factor for poor CVD in addition to DM in patients with CTO.