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Effect of obesity on coronary collateral vessel development in patients with coronary artery disease
Ersan Tatli1, Mustafa Yildiz, Cetin Gül
1Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey. ersantatli@hotmail.com
Insights
This study found that while obesity and overweight patients had more risk factors, coronary collateral circulation was not significantly affected in obese patients with coronary artery disease. Further research is needed to understand this complex relationship.
Area of Science:
- Cardiology
- Vascular Biology
- Metabolic Syndrome
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Coronary collateral circulation (CCC) plays a crucial role in mitigating ischemic damage.
- The relationship between body mass index (BMI) and CCC in CAD patients remains incompletely understood.
Purpose of the Study:
- To investigate the association between different body mass index (BMI) categories and coronary collateral circulation (CCC) in patients with coronary artery disease (CAD).
- To compare the prevalence of cardiovascular risk factors among different BMI groups in the study population.
Main Methods:
- A retrospective analysis of 90 first-time angiography patients with single-vessel CAD between January 1999 and December 2001.
- Patients were categorized by BMI (normal, overweight, obese) and CCC (insufficient vs. sufficient).
- Data on age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia, preinfarction angina, and medication use were collected and analyzed.
Main Results:
- Obesity and overweight groups exhibited higher frequencies of hyperlipidemia, diabetes mellitus, and nitrate use (p < 0.05).
- Use of oral nitrates >6 months pre-myocardial infarction and preinfarction angina positively influenced collateral coronary vessel development (p = 0.01, p = 0.03).
- No statistically significant correlation was found between CAD and CCC development in obese patients (p = 0.6), despite a trend towards negative impact.
Conclusions:
- While obese patients with CAD showed a trend towards impaired collateral vessel development, this did not reach statistical significance in this cohort.
- Cardiovascular risk factors like hyperlipidemia and diabetes were more prevalent in overweight and obese individuals.
- Preinfarction angina and long-term nitrate use were associated with better collateralization, suggesting potential therapeutic implications.
Abstract:
The purpose of this study was to compare coronary collateral circulation and with other risk factors in patients with coronary artery disease and different body mass index. Between January 1999 and December 2001, of 867 patients who underwent angiography for the first time, 90 patients (24 women and 66 men), with occlusion in only 1 coronary artery participated in the study. Information regarding age, body mass index, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia, preinfarction angina, and use of oral beta blockers and nitrates were recorded for all patients. The patients were separated into 2 groups in accordance with development of their coronary collateral circulation; those with insufficient (Rentrop 0, 1, and 2) and those with sufficient coronary collateral circulation. They were also divided into 3 groups on the basis of body mass index as follows: (I) 18.0-24.9 kg/m(2), (II) 25.0-29.9 kg/m(2), and (III) more than 30 kg/m(2). In the obesity and overweight groups, hyperlipidemia, diabetes mellitus, and nitrate use were identified more frequently than in the other groups (p < 0.05). Use of oral nitrates more than 6 months before the myocardial infarction and existence of preinfarction angina affected collateral coronary vessel development in the positive direction (p = 0.01, p = 0.03, respectively). There was no correlation between coronary artery disease and coronary collateral vessel development in the obese patients (p = 0.6). Although it has been shown that coronary collateral vessel development was affected negatively in obese patients with coronary artery disease, no statistical significance was identified.
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