Impaired coronary collateral vessel development in patients with proliferative diabetic retinopathy

• Published in: Clinical cardiology (Mahwah, N.J.) N.J.), 2005-08, Vol.28 (8), p.384-388
• Main Authors: Celik, Turgay, Berdan, M. Eyup, Iyisoy, Atila, Kursaklioglu, Hurkan, Turhan, Hasan, Kilic, Selim, Gulec, Mustafa, Ozturk, Sami, Isik, Ersoy
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; Clinical Investigation; Clinical Investigations; Collateral Circulation - physiology; coronary collateral vessels; Coronary Disease - physiopathology; Coronary Vessels - physiopathology; diabetes mellitus; Diabetes. Impaired glucose tolerance; diabetic retinopathy; Diabetic Retinopathy - blood; Diabetic Retinopathy - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Ophthalmology; Retinopathies; vascular endothelial growth factor; Vascular Endothelial Growth Factor A - blood
• ISSN: 0160-9289; 1932-8737
• DOI: 10.1002/clc.4960280808

Background: Diabetic patients have been reported to have impaired coronary collateral vessel growth, although they have excessive neovascularization in the retina. Hypothesis: This study was designed to compare coronary collateral circulation (CCC) in patients with proliferative diabetic retinopathy (PDR) with that in patients without DR. Methods: Ninety diabetic patients with chronic total occlusion in at least one major epicardial coronary artery were enrolled in the study. Groups 1 and 2 consisted of 48 patients without DR and 42 patients with PDR, respectively. Coronary collateral circulation (CCC) was analyzed according to the Rentrop system. Each group was also divided into two subgroups according to poor and good CCC. Serum vascular endothelial growth factor (VEGF) levels were measured using the enzyme‐linked immunosorbent assay (ELISA) kit. Results: The mean Rentrop collateral score was higher in Group 1 than in Group 2 (2.39 ± 1.07 vs. 1.76 ± 0.76, respectively, p < 0.001). When the two groups were compared with respect to poor and good CCC, poor CCC was higher in patients with PDR (64 vs. 36%, respectively, p = 0.01). Serum VEGF levels were higher in patients with PDR than in those without DR (219 ± 99 vs. 139 ± 98 pg/ml, p < 0.001); however, patients with poor and good CCC had similar VEGF levels. Conclusions: We have shown that patients with PDR have a lower coronary collateral score than patients without DR. Also, serum VEGF was significantly higher in patients with PDR than in those without DR. These findings have suggested that diabetes mellitus may have a different action on retinal and coronary circulation.