title: Impaired coronary collateral vessel development in patients with proliferative diabetic retinopathy.
abstract: BACKGROUND
  Diabetic patients have been reported to have impaired coronary collateral vessel growth, although they have excessive neovascularization in the retina.
  
  
  OBJECTIVE
  This study was designed to compare coronary collateral circulation (CCC) in patients with proliferative diabetic retinopathy (PDR) with that in patients without DR.
  
  
  METHODS
  Ninety diabetic patients with chronic total occlusion in at least one major epicardial coronary artery were enrolled in the study. Groups 1 and 2 consisted of 48 patients without DR and 42 patients with PDR, respectively. Coronary collateral circulation (CCC) was analyzed according to the Rentrop system. Each group was also divided into two subgroups according to poor and good CCC. Serum vascular endothelial growth factor (VEGF) levels were measured using the enzyme-linked immunosorbent assay (ELISA) kit.
  
  
  RESULTS
  The mean Rentrop collateral score was higher in Group 1 than in Group 2 (2.39 +/- 1.07 vs. 1.76 +/- 0.76, respectively, p < 0.001). When the two groups were compared with respect to poor and good CCC, poor CCC was higher in patients with PDR (64 vs. 36%, respectively, p = 0.01). Serum VEGF levels were higher in patients with PDR than in those without DR (219 +/- 99 vs. 139 +/- 98 pg/ml, p < 0.001); however, patients with poor and good CCC had similar VEGF levels.
  
  
  CONCLUSIONS
  We have shown that patients with PDR have a lower coronary collateral score than patients without DR. Also, serum VEGF was significantly higher in patients with PDR than in those without DR. These findings have suggested that diabetes mellitus may have a different action on retinal and coronary circulation.
authors.affiliation: The Department of Cardiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey. benturgay@yahoo.com
authors.forename: Turgay
authors.initials: T
authors.lastname: Celik
authors.forename: M Eyup
authors.initials: ME
authors.lastname: Berdan
authors.forename: Atila
authors.initials: A
authors.lastname: Iyisoy
authors.forename: Hurkan
authors.initials: H
authors.lastname: Kursaklioglu
authors.forename: Hasan
authors.initials: H
authors.lastname: Turhan
authors.forename: Selim
authors.initials: S
authors.lastname: Kilic
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gulec
authors.forename: Sami
authors.initials: S
authors.lastname: Ozturk
authors.forename: Ersoy
authors.initials: E
authors.lastname: Isik
mesh_terms: D000368:Aged; D003097:Collateral Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000503:physiopathology*; D003331:Coronary Vessels / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D042461:Vascular Endothelial Growth Factor A