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. 2002 Jan;87(1):61-6.
doi: 10.1136/heart.87.1.61.

Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during angioplasty

Z S Kyriakides  1 , S Psychari, N Chrysomallis, M Georgiadis, E Sbarouni, D T Kremastinos
Affiliations

Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during angioplasty

Z S Kyriakides et al. Heart. 2002 Jan.

Abstract

Objective: To test whether type II diabetes prevents the recruitment of collaterals and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty.

Methods: Two groups of patients were studied. A collateral circulation group consisted of 56 patients, 18 diabetic and 38 non-diabetic. All underwent a minimum of three balloon inflations. A pressure guide wire was used for the measurement of coronary wedge pressure (mm Hg). The angioplasty protocol was repeated in another group of 57 patients (myocardial ischaemia group) using both surface and intracoronary ECGs to assess myocardial ischaemia.

Results: In diabetic patients, mean (SD) coronary wedge pressure was 35 (12) mm Hg during the first balloon inflation, 39 (15) mm Hg during the second (p < 0.05 v first inflation), and 42 (17) mm Hg during the third (p < 0.05 v first inflation); in non-diabetic patients the respective values were 36 (16), 37 (16), and 37 (16) mm Hg (F = 4.73, p = 0.01). The ratio of coronary wedge pressure to mean arterial pressure in diabetic patients in the three balloon inflations was 0.33 (0.11), 0.36 (0.13), and 0.39 (0.15), respectively (p < 0.05 v the first inflation); and in non-diabetic patients it was 0.33 (0.15), 0.34 (0.15), and 0.35 (0.15) (F = 1.92, p = 0.15). In the diabetic group the response was independent of the type of treatment. No difference between diabetic and non-diabetic patients was observed in the normal reduction of myocardial ischaemia on repeated balloon inflations.

Conclusions: Type II diabetes does not prevent the recruitment of collateral vessels and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty in single vessel disease, regardless of the type of antidiabetic treatment.

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Figures

Figure 1
Figure 1
Mean individual values of coronary wedge (CWP) pressure at the end of the first, second, and third balloon inflations (BI) in the two subgroups (diabetic and non-diabetic) of the coronary circulation group. In the diabetic patients CWP increased progressively between the three balloon inflations. In contrast, in the non-diabetic patients CWP did not increase significantly.
Figure 2
Figure 2
Mean individual values of coronary wedge pressure (CWP)/mean arterial pressure at the end of the first, second, and third balloon inflations (BI) in the two subgroups (diabetic and non-diabetic) in the coronary collateral group. In the diabetic patients, the CWP/mean arterial pressure increased significantly from the first to the third inflation. In contrast, in the non-diabetic patients this change was not significant.
See this image and copyright information in PMC

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