Key result
Type II diabetes is not associated with impaired coronary collateral recruitment or blunted ischemia reduction.
Why the study?
It was uncertain whether type II diabetes prevents the recruitment of collateral vessels and the normal reduction of myocardial ischaemia during repeated balloon inflations in coronary angioplasty.
Does type II diabetes prevent the recruitment of collaterals and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty?
Observational (n=113)
Does type II diabetes prevent the recruitment of collaterals and the normal reduction of myocardial ischaemia on repeated balloon inflations during coronary angioplasty?
Absolute Event Rate: 42% vs 37%
p-value: p=0.01
Type II diabetes does not prevent the recruitment of collateral vessels or the normal reduction of myocardial ischaemia during repeated balloon inflations in single vessel coronary angioplasty.
Clinicians may maintain standard expectations for diabetic patients during angioplasty; extends prior observations but requires prospective validation.
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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Tom Wong (2002) conducted an observational in Single vessel disease undergoing coronary angioplasty (n=113). Type II diabetes vs. Non-diabetic patients was evaluated on Coronary wedge pressure during repeated balloon inflations (p=0.01). Type II diabetes did not prevent the recruitment of collateral vessels (coronary wedge pressure 42 vs 37 mm Hg at third inflation; P=0.01) or the normal reduction of myocardial ischaemia.
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