Corrected thrombolysis in myocardial infarction frame counts in diabetic patients with angiographically normal coronary arteries Sedat Turkoglu, MD, Murat Ozdemir, MD, FESC, Gulten Tacoy, MD, Yusuf Tavil, MD, Adnan Abaci, MD, FESC, Timur Timurkaynak, MD, FESC, Atiye Cengel, MD, FESC.
ABSTRACT
من أجل تقييم تعداد إطار انحالل اخلثرة املصحح:األهداف ) لدى املرضى املصابني بداء السكري والذين كانتCTFC( هنالك،نتيجة تخطيط األوعية للشرايني التاجية لديهم طبيعية .حالة أخرى تعرف باحتادها مع توقف وظيفة األوعية الدقيقة متت دراسة حالة املرضى الذين خضعوا لتخطيط:الطريقة خالل الفترة،الشريان التاجي مبستشفى جامعة غازي – تركيا مت حساب تعداد إطار.م2005 م وحتى يناير2000 ما بني يناير )CTFC( انحالل اخلثرة املصحح في احتشاء عضلة القلب )CX( ) واملنعطف األيسرLAD( على مدى النازل األمامي ، مريض ًا بالسكري118 ) لدىRCA( والشرايني التاجية اليمنى غير مصاب بالسكري ونتيجة تخطيط الشريان التاجي122و .لديهم طبيعية
Objectives: To evaluate corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) in patients with angiographically normal coronary arteries and diabetes mellitus, a condition known to be associated with microvascular dysfunction. Methods: Patients who underwent coronary angiography in Gazi University Hospital, Ankara, Turkey between January 2000 and January 2005 were studied. Corrected TIMI frame count was calculated over the left anterior descending (LAD), left circumflex (Cx) and right coronary arteries (RCA) in 118 diabetic and 122 non-diabetic patients with normal coronary angiogram.
كانت قيم تعداد إطار انحالل اخلثرة املصحح في احتشاء:النتائج )RCA() وCX() وLAD( ) الفعلية لـCTFC( عضلة القلب مشـــابهة لدى مرضــى الســـكري والغير مصـــابني بالســــــــــــكري
Results: The mean CTFC values of the LAD, Cx, and the RCA were similar in diabetics and nondiabetics (21.0±7.5 versus 21.3±9.6, 23.3 ± 9.7 versus 23.5 ± 10.8, 17.9 ± 6.7 versus 18.7 ± 7.4 respectively, p>0.05 for all comparisons). In stepwise multivariate linear regression analysis, body surface area had a significant correlation with CTFC of all the 3 coronary arteries.
كان لدى حتليل تراجع املتغير املتعدد اخلطي ومنطقة سطح اجلسم ) ذات صلة ملحوظة مع تعداد إطار انحالل اخلثرة املصححBSA( ) في احتشاء عضلة القلب جلميع الشرايني التاجيةCTFC( .الثالثة
Conclusion: We conclude that CTFC in diabetics and non-diabetics with angiographically normal coronary arteries is similar. Since microvascular disease is an inherent component of diabetes, our finding may reflect the inadequacy of CTFC in predicting microvascular disease in diabetic patients with normal coronary angiograms.
(21.0±7.5 versus 21.3±9.6, 23.3 ± 9.7 versus 23.5 ± 10.8, 17.9 ± 6.7 versus 18.7 ± 7.4) في خطوة محكمة.) جلميع املقارننيp>0.05( على التوالي
)CTFC( وجدن أن تعداد إطار انحالل اخلثرة املصحح:خامتة ) لدى املصابني بالسكريCTFC( في احتشاء عضلة القلب وغير املصابني والذين لديهم نتيجة تخطيط الشرايني التاجية نظراً لكون مرض األوعية الدقيقة مكون وراثي.طبيعية مشابهة فقد تعكس دراستنا استقاللية تعداد إطار انحالل،للسكري ) في التكهنCTFC( اخلثرة املصحح في احتشاء عضلة القلب مبرض األوعية الدقيقة لدى املرضى املصابني بداء السكري والذين .نتيجة تخطيط الشريان التاجي لديهم طبيعية 1164
Saudi Med J 2008; Vol. 29 (8): 1164-1167 From the Department of Cardiology, Gazi University School of Medicine, Ankara, Turkey. Received 16th February 2008. Accepted 9th July 2008. Address correspondence and reprint request to: Dr. Sedat Turkoglu, Department of Cardiology, Gazi University School of Medicine, 06500, Besevler, Ankara, Turkey. Fax. +90 (312) 2129012. Tel. +90 (312) 2025629. E-mail:
[email protected]
Corrected TIMI frame counts in diabetic patients ... Turkoglu et al
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orrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) is a valuable tool to evaluate angiographic outcomes following reperfusion,1 and it has a prognostic importance.2,3 It was also shown that CTFC of nonculprit arteries in patients with acute myocardial infarction was significantly higher compared with the normal arteries in the absence of acute myocardial infarction.1 Moreover, CTFC has recently been shown to be higher in patients with metabolic syndrome and normal coronary angiograms, implying that CTFC may show microvascular dysfunction of the coronary bed in the absence of atherosclerotic lesions in the epicardial coronary arteries.4 Type 2 diabetes mellitus is a disease that is well known to be associated with microvascular dysfunction.5-7 To our knowledge, no study has yet investigated CTFC in diabetic patients with angiographically normal coronary arteries. The aim of this study was to investigate the CTFC in diabetic and non-diabetic patients with normal coronary angiograms. Methods. In this retrospective study, participants were identified through a review of our angiography database of 7141 patients who underwent coronary angiography from January 1, 2000 to January 1, 2005. Two groups were selected according to the following criteria: 1. The non-diabetic group consisted of patients with no previous diagnosis of diabetes and a pre-procedural fasting blood glucose level
