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European Heart Journal Advance Access published online on January 22, 2009
European Heart Journal, doi:10.1093/eurheartj/ehn569
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Metabolic syndrome and collateral vessel formation in patients with documented occluded coronary arteries: association with hyperglycaemia, insulin-resistance, adiponectin and plasminogen activator inhibitor-1

Frédéric Mouquet1,5,{dagger}, François Cuilleret1,{dagger}, Sophie Susen2,5, Karine Sautière1, Philippe Marboeuf1, Pierre Vladimir Ennezat1,5, Eugène McFadden1, Pascal Pigny3, Florence Richard7, Bernadette Hennache3, Marie Christine Vantyghem4, Michel Bertrand1, Jean Dallongeville6, Brigitte Jude2,5 and Eric Van Belle1,5,*

1 Departments of Cardiology, Centre Hospitalier Régional Universitaire, 59037-Lille, France
2 Department of Hematology, Centre Hospitalier Régional Universitaire, 59037-Lille, France
3 Department of Biochemistry, Centre Hospitalier Régional Universitaire, 59037-Lille, France
4 Department of Diabetology, Centre Hospitalier Régional Universitaire, 59037-Lille, France
5 Université de Lille 2, EA 2693, 59037 Lille, France
6 INSERM U744, Lille, France
7 Institut Pasteur de Lille, France

Received 20 May 2008; revised 25 November 2008; accepted 27 November 2008.

* Corresponding author. Tel: +33 3 20 44 50 08, Fax: +33 3 20 53 51 30, Email: ericvanbelle{at}aol.com

Aims: The metabolic syndrome (MS) is associated with an increased cardiovascular risk. Patients with the MS have endothelial dysfunction, decreased circulating adiponectin, and a high expression of angiogenic inhibitors such as plasminogen activator inhibitor-1 (PAI-1). We hypothesized that such patients, in the event of a coronary occlusion, might exhibit a less developed collateral circulation.

Methods and results: Three hundred and eighty-seven consecutive patients with at least one coronary occlusion of a major coronary vessel at diagnostic angiography were prospectively enrolled. Collateral development was graded with validated angiographic methods. The MS was defined according to the ATP-III definition. Fasting glucose, adiponectin, insulin concentrations, and PAI-1 were measured at the time of angiography. MS was associated with less developed collateral vessels (P = 0.005). In multivariable analysis adjusting for potential confounding factors including the duration of coronary occlusion (P = 0.0001), fasting glycaemia (P = 0.0007), low adiponectin concentration (P = 0.01), insulin-resistance (HOMA-IR; P = 0.01), high circulating PAI-1 concentration (P = 0.01), and hypertension (P = 0.008) were independently associated with poor coronary collateral vessel development.

Conclusion: This study shows that in patients with coronary occlusion, collateral circulation is impaired in patients with the MS. This association is partly related to fasting glycaemia and to key parameters linked to insulin resistance.

Key Words: Angiogenesis • Collateral circulation • Coronary disease • Diabetes mellitus • Fibrinolysis • Insulin

{dagger} Frédéric Mouquet and François Cuilleret contributed equally to this work.


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E-letters:

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Negative predictors of collateral formation: Evidence based on novel functional and mechanistic data
Johannes Waltenberger, et al.
European Heart Journal, 9 Sep 2009 [Full text]
Underlying mechanisms of decreased collateral formation in patients with Metabolic Syndrome
Eric Van Belle, et al.
European Heart Journal, 9 Sep 2009 [Full text]

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