Carbohydrate metabolism disorders and coronary collateral circulation in patients with chronic coronary artery disease

Abstract

Aim. To evaluate the association between coronary collateral circulation (CCC) and carbohydrate metabolism disorders (CMD) in patients with chronic coronary artery disease (CAD). Materials and Methods. Six hundred three patients with chronic CAD were included in this cohort cross-sectional study. Coronary angiography images were used to quantify coronary circulation, including CCC evaluation, with a modified technique proposed by Rentrop. CMD were classified according to the WHO criteria.Potential associations between CMD and CCC were evaluated using multiple linear models that incorporated major angiographic, clinical and laboratory parameters. Results. Among the 603 patients with chronic CAD, 47.4 had CMD, including type 2 diabetes mellitus in 24.2% of the patients, impaired glucose tolerance in 2.8%, type 1 diabetes mellitus in 1.0% and unspecified CMD in 16.1%. CMD were independently associated with lower CCC [odds ratio (OR). = 0.96, p . = 0.003). CMD were independently associated with a decrease in the association . between maximum diameter stenosis and CCC (OR = 0.93, p. = 0.005). No independent associations were found between CCC and type of anti-diabetic treatment, HbA1c levels, insulin resistance (HOMA index), or metabolic syndrome components (body mass index, triglycerides, fasting glucose levels, LDLP cholesterol and arterial hypertension). Conclusion. CMD in patients with chronic CAD are . independently associated with worse CCC. The presence of CMD weakens . the association between maximum diameter stenosis and CCC. Metabolic syndrome components, blood glucose control and anti-diabetic treatment modality were not found to influence CCC.

Keywords

• collateral circulation, carbohydrate metabolism, coronary artery disease