Comparison of coronary artery flow impairment in diabetic and ipertensive patients with stable microvascular angina

OBJECTIVE : Stable microvascular angina (SMVA) describes patients with angina, findings compatible with myocardial ischemia and normal coronary angiograms. The aim of this study was to evaluate the impact of diabetes on the coronary microcirculation troughs angiogra - phy indexes (TIMI Frame Count, Myocardial Blush Grade, Total Myocardial Blush Score) and a new index:TotalTIMIFrameCount(TTFC). PATIENTS AND METHODS: The study popula - tion included 310 patients with SMVA that we split into two populations: diabetic-non hyper - tensive (164 patients) and non-diabetic- hypertensive (146 patients). We calculated, on angiographic images of each patient,TIMI Frame Count (TFC), Myocardial Blush Grade (MBG) and Total Myocardial Blush Score (TMBS) using the protocol described by Gibson andYusuf. On the basis of Yusuf's experience we imagined a new index:TTFC like sum of the three coronaryTFC. RESULTS: We found a worse coronary microcir - culation in diabetic-non hypertensive patients with lower values of TFC, MBG and TMBS ( p = 0.02), compared with non-diabetic hypertensive. New indexTTFC is usually higher in diabetic-non hypertensive than non-diabetic hypertensive pa - tients. Patients with positive scintigraphy had a worse TMBS than patients with a negative one, withahighstatisticalsignificance( p=0.003). CONCLUSIONS: Analysis of diabetic non hy - pertensive and non-diabetic and hypertensive patients with cardiac syndrome X has led to ass - es that the diabetic population has a greater in - volvement of microcirculation. Also the new in - dex,TTFC, proved to be a good marker, in agree - ment with results of other indexes.