Cor Vasa 2019, 61(6):567-572 | DOI: 10.33678/cor.2019.010

Non-infarct related chronically occluded coronary arteries and its association with diabetes and prediabetes

Mustafa Karanfil, Ahmet Akdi, Mustafa Bilal Ozbay, Meryem Kara, Ozcan Ozeke, Serkan Cay, Adnan Burak Akcay, Serkan Topaloglu, Dursun Aras
Department of Cardiology, Health Sciences University, Ankara City Hospital, Ankara, Turkey

Background: Chronic coronary total occlusions (CTOs) are mostly associated with infarct-related artery (IRA CTO); however, all CTOs may not always lead to or be caused by STEMI. Clinical profile of patients with non-infarct-related artery related CTOs (non-IRA CTO) might give us endogenous cardioprotective mechanisms activated in response to myocardial ischemia caused by atherosclerotic process.

Objective: We aimed to evaluate the clinical profile of non-IRA CTO with regard to cardiovascular risk factors.

Methods: We reviewed our invasive cardiology database searching for the non-IRA CTO of any major coronary arteries, and assessed whether or not they have the clinical history or electrocardiographic (Q waves, loss of R wave), echocardiographic or left ventriculographic (segmental wall motion abnormality) evidence of previous myocardial infarction. The rates of non-IRA CTO were compared among diabetes, prediabetes and non-diabetic/prediabetic control groups.

Results: This was a cross-sectional study of 2180 patients who underwent coronary angiogram for the evaluation of stable coronary artery disease at a tertiary care hospital from January 2018 to April 2018. We detected 41 consecutive patients with non-IRA CTO (1.9%) with a low prevalence of smoking (7%). The most of patients (93%) had either DM (61%) or prediabetes (32%), and this was statistically different from non-diabetic/prediabetic patients (p ≤ 0.001).

Conclusion: Non-IRA CTOs have been found to be associated with prediabetes and diabetes. Whereas the DM and prediabetes aggressively induces atherosclerosis, they can also activate some endogenous cardioprotective mechanisms protecting the left ventricular contractile function.

Keywords: Atherothrombosis, Chronic total occlusions, Coronary atherosclerosis, Diabetes mellitus, Non-infarct related chronic total occlusions, Prediabetes

Received: February 4, 2019; Accepted: March 24, 2019; Published: December 15, 2019  Show citation

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Karanfil M, Akdi A, Ozbay MB, Kara M, Ozeke O, Cay S, et al.. Non-infarct related chronically occluded coronary arteries and its association with diabetes and prediabetes. Cor Vasa. 2019;61(6):567-572. doi: 10.33678/cor.2019.010.
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