Effect of glucometabolic disorders on the formation of coronary collaterals in occlusive coronary artery disease

Objective - The primary aim of this study was to assess the effect of glucometabolic disorders on coronary collateral vessels in patients with occlusive coronary artery disease. Methods and results - Hundred and ninety-five consecutive patients with at least single-vessel occlusion were enrolled in this study prospectively. The standard oral glucose tolerance test was performed according to the criteria of the World Health Organization. Collateral circulation was graded according to the Rentrop classification. The mean Rentrop scores in normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and diabetes were 1.40 +/- 1.02, 1.05 +/- 0.84, 1.00 +/- 0.98, respectively (P = 0.043). The percentage of patients without collateral circulation (Rentrop-0) was greatest in the diabetic group (44.4%), while the percentage was 21.8% in the IGT group and 22.0% in the NGT group. Ninety-five patients with at least one totally occluded coronary artery were analysed as a subgroup. In the totally occluded artery subgroup postprandial glycaemia was the only parameter that was associated with the Rentrop score in the univariate analysis (r = -0.34, P = 0.002) Conclusions - In conclusion, our study results, which are in agreement with previous results, indicate that not only diabetic glucose tolerance but also impaired glucose tolerance has an adverse impact on the development of coronary collaterals.