The following is a summary of “Microvascular Complications Are Associated With Coronary Collateralization in Type 2 Diabetes and Chronic Occlusion,” published in the January 2024 issue of Endocrinology by Gurgoglione, et al.

In the context of coronary chronic total occlusion (CTO), coronary collateral (CC) vessel development has been recognized as a protective factor against adverse cardiovascular events and mortality. However, the impact of type 2 diabetes mellitus (T2DM) on CC growth has been subject to debate, particularly concerning diabetic microvascular complications (DMC) and their role in coronary collateralization. For a study, researchers sought to investigate potential differences in CC vessel presence and grading between T2DM patients with and without DMC.

The observational study was conducted at a single center and included consecutive T2DM patients without prior cardiovascular history who underwent coronary angiography for chronic coronary syndrome (CCS) and exhibited at least one CTO. Patients were categorized into two groups based on the presence or absence of DMC (neuropathy, nephropathy, or retinopathy). The presence and grading of angiographically visible CC development from patent vessels to the occluded artery were assessed using the Rentrop classification.

A total of 157 patients participated in the study, with a mean age of 68.6 ± 9.8 years, of whom 120 (76.4%) were men. Patients with DMC (75 [47.8%]) exhibited a higher prevalence of CC (69 [92.0%] vs. 62 [75.6%], P = .006) and high-grade CC (55 [73.3%] vs. 39 [47.6%], P = .001) compared to those without DMC. Furthermore, a positive association was observed between the number of DMC in each patient and the prevalence of high-grade CC.

In T2DM patients with coronary CTO, DMC was significantly associated with a higher development of CC.

Reference: academic.oup.com/jcem/article-abstract/109/1/237/7220961