Effect of Statin Treatment on Coronary Collateral Development in Patients With Diabetes Mellitus

• Published in: The American journal of cardiology 2006-03, Vol.97 (6), p.772-774
• Main Authors: Dincer, Irem, Ongun, Aydan, Turhan, Sibel, Ozdol, Cagdas, Ertas, Fatih, Erol, Cetin
• Format: Article
• Language: English
• Subjects: Angina pectoris; Angina Pectoris - physiopathology; Atorvastatin Calcium; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Cholesterol, LDL - blood; Collateral Circulation - drug effects; Coronary Angiography; Coronary Disease - drug therapy; Coronary Disease - physiopathology; Coronary heart disease; Diabetes; Diabetes Mellitus - drug therapy; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Drug therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Heart; Heptanoic Acids - pharmacology; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypotheses; Male; Medical sciences; Middle Aged; Multivariate Analysis; Odds Ratio; Pravastatin - pharmacology; Pravastatin - therapeutic use; Pyrroles - pharmacology; Pyrroles - therapeutic use; Retrospective Studies; Simvastatin - pharmacology; Simvastatin - therapeutic use; Statins
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2005.09.124

Coronary collateral development is an important compensatory mechanism in advanced coronary artery disease, and patients with diabetes mellitus have impaired coronary collateral development. This study tested the hypothesis that statin treatment may increase coronary collateral development in patients with diabetes mellitus. The study population consisted of 149 consecutive diabetic patients who underwent clinically indicated coronary angiography and had >95% stenosis of ≥1 major coronary artery. Clinical information, including age, gender, history of hypertension, smoking, myocardial infarction, clinical presentation, and medications, was recorded before coronary angiography. Coronary collaterals were graded according to the Cohen-Rentrop method. Collateral grading was classified as poor when the collateral grade was 0 to 1 and good when it was 2 to 3. Among 149 patients (85 men; mean age 62 ± 10 years), 74 (56%) were receiving statin treatment. In multivariate analysis, among demographic, clinical, and angiographic parameters, only statin therapy (odds ratio 3, 95% confidence interval 1.5 to 6.03, p = 0.002) and stable angina pectoris (odds ratio 3.24, 95% confidence interval 1.42 to 7.41, p = 0.005) were found to be independent predictors of better collateral formation. In conclusion, stable angina pectoris and statin treatment are associated with better coronary collateral development in patients with diabetes mellitus.