Collateral circulation in coronary artery disease

Elayda, MacArthur A.; Mathur, Virendra S.; Hall, Robert J.; Massumi, G.Ali; Garcia, Efrain; Castro, Carlos M. de

doi:10.1016/0002-9149(85)90299-1

Cited by 60 publications

(22 citation statements)

References 23 publications

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“…[1][2][3][4][5] Studies limited to occluded arteries support a positive correlation between the presence of coronary collaterals and preserved left ventricular function. 12,16.22 Recently, Saito et a113 found that among patients with successful thrombolysis, those with good collaterals showed more improvement in left ventricular function (acute vs. late measurements) than those without.…”

Section: Discussionmentioning

confidence: 92%

Potential protective effect of high coronary wedge pressure on left ventricular function after coronary occlusion.

et al. 1988

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To assess the potential of coronary collateral circulation to protect myocardium after occlusion of a coronary vessel, the mean coronary wedge pressure, the angiographic grade of Experimentally, the coronary collateral circulation has been studied mainly in the dog heart. Because collaterals are more developed in dogs than in healthy humans, the results can not necessarily be extrapolated to the human coronary circulation. The hemodynamics of coronary collaterals have been studied directly in humans during aortocoronary bypass surgery,17 and, more recently, the From the Cardiology Center, University Hospital, Geneva, Switzerland.Address for correspondence: B. Meier, MD, Cardiology Center, University Hospital, 1211 Geneva 4, Switzerland.Received November 20, 1987; revision accepted April 28, 1988. pressure distally to coronary lesions was measured during percutaneous angioplasty18-22 and the relation of the coronary wedge pressure (pressure in the distal part of the occluded artery) to spontaneously visible and recruitable collaterals has been established.22 To evaluate the protective role of the coronary collateral circulation, we studied the relation between the mean coronary wedge pressure measured during percutaneous transluminal coronary angioplasty and the left ventricular function in patients with occlusion of a major coronary vessel. Patients and Methods PatientsCoronary wedge pressure measurements were done in 53 of 108 consecutive patients with attempted recanalization of a total coronary occlusion. Four patients with a previous myocardial infarction in a region other than that supplied by the attempted vessel were excluded. Two additional patients were excluded because of unsatisfactory quality of the left ventriculogram. The remaining 47 patients constituted the study population. Among them, 13 patients underwent mechanical recanalization during the acute phase of a myocardial infarction. The remaining 34 underwent an elective procedure for a

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Section: Discussionmentioning

confidence: 92%

Potential protective effect of high coronary wedge pressure on left ventricular function after coronary occlusion.

et al. 1988

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“…True collateral vessels are not seen angiographically in normal hearts, and coronary arteries must be occluded 99% or 100% for CC to be visible (2). Collaterals are capable of blood supply to a myocardial area jeopardized by ischemia.…”

Section: Introductionmentioning

confidence: 99%

Determinants of coronary collateral circulation in patients with coronary artery disease

Zorkun¹,

Akkaya²,

Zorlu³

et al. 2012

Anadolu Kardiyol Derg

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Objective: This study aims to identify possible determinants of coronary collaterals in patients with severe coronary artery disease. Methods: The current study has a retrospective cohort design. Seventy four patients with ≥90% stenosis or total occlusion of the left anterior descending artery (LAD) were enrolled; coronary collateral grades, high-sensitive C-reactive protein (hs-CRP), fibrinogen, protein C and S, lipids, uric acid levels and medications applied before coronary angiography were noted and compared. Multiple logistic regression analysis was used for the multivariate analyses of independent variables associated with the development of adequate coronary collateral vessels. Results: The presence of coronary collaterals was significantly higher in males (p=0.018), with higher hs-CRP (p=0.023), prior statin use (p=0.022), and higher Gensini scores (p<0.001). In multiple logistic regression analysis, hs-CRP levels (OR=0.94, 95.0% CI=0.883-1.000, p=0.048), male gender (OR=4.73, 95.0% CI=1.441-15.539, p=0.010) and prior statin usage (OR=4.70, 95.0% CI=1.264-17.452, p=0.021) were identified as independent predictors of coronary collateral development. Conclusion: Male gender, prior statin usage, and higher hs-CRP levels are determinants of coronary collaterals in patients with coronary artery disease. (Anadolu Kardiyol Derg 2013; 13: 146-51) Key words: Coronary collateral circulation, coronary artery disease, high-sensitivity C-reactive protein, regression analysis Original Investigation Özgün Araşt›rma 146ÖZET Amaç: Bu çalışmada ciddi koroner arter hastalığı olanlarda koroner kollateral gelişimini sağlayan muhtemel nedenler araştırılmıştır. Yöntemler: Bu çalışma retrospektif kohort dizayna sahiptir. Sol ön inen arterde (SÖİA)-%90 ve daha fazla darlığı olan ya da (SÖİA) arteri tamamen tıkalı olan 74 hasta çalışmaya alınmıştır. Hastaların yüksek duyarlıklı C-reaktif protein (hs-CRP), fibrinojen, protein C ve S, lipid değerleri, ürik asit düzeyleri ile kullandığı ilaçlar tespit edilmiş ve koroner kollateral gelişimine göre karşılaştırılmıştır. Yeterli koroner kollateral gelişimi ile ilişkili bağımsız değişkenlerin belirlenmesinde çoklu lojistik regresyon analizi kullanılmıştır. Bulgular: Koroner kollateral gelişimi, erkek cinsiyette (p=0.018), önceden statin kullananlarda (p=0.022), yüksek hs-CRP düzeyi olanlarda (p=0.023) ve yüksek Gensini skoruna (p<0.001) sahip olan kişilerde daha fazla tespit edildi. Çoklu lojistik regresyon analizinde; hs-CRP düzeyleri (OR=0.94, %95.0 CI=0.883-1.000, p=0.048), erkek cinsiyet (OR=4.73, %95.0 CI=1.441-15.539, p=0.010) ve önceden statin kullanımı (OR=4.70, %95.0 CI=1.264-17.452, p=0.021) koroner kollateral gelişiminin bağımsız belirleyicileri olarak tespit edildi. Sonuç: Koroner arter hastalığı olanlarda erkek cinsiyet, statin kullanımı ve yüksek hs-CRP düzeyleri koroner kollateral gelişiminin belirleyicileridir.

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“…Consequently, they frequently go undetected on coronary angiograms because they only carry low blood flow. To make the collateral vessels visible, it is necessary for the coronary artery to be obstructed 99% or 100% [4]. It is noteworthy that the CCC process involves clinical parameters such as the duration of cardiac ischaemia, blood vessel formation, and inflammation [5,6].…”

Section: Introductionmentioning

confidence: 99%

The relationship between ischaemia-modified albumin and good coronary collateral circulation

Gök¹,

Kundi²,

Kızıltunç³

et al. 2018

Kardiol Pol

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A b s t r a c t Background:It is important to determine the grade of the coronary collateral circulation (CCC) in patients with stable coronary artery disease. Aim:In this study, we aimed to investigate the relationship between the ischaemia-modified albumin (IMA) level and good CCC. Methods:A total of 95 patients with coronary angiography and at least one epicardial coronary artery obstruction were included in the study. The Rentrop classification was used with CCC grading, where 0 and 1 were defined as poor collateral, and 2 and 3 were defined as good collateral. The IMA level of the patients was measured using an enzyme-linked immunosorbent assay (ELISA). The receiver-operating characteristic curve was used to show the sensitivity and specificity of IMA levels and the optimal cut-off value for predicting good CCC. Results:The multiple logistic regression analysis revealed that the IMA level in the good CCC group was higher (p < 0.045). Conversely, the high-sensitivity C-reactive protein level was lower in the good CCC group (p < 0.023). We found an IMA cut-off value (4.7 ng/mL) that indicated good CCC level, and this shows good CCC with 70.2% sensitivity and 60.3% specificity. Conclusions:The IMA level could serve as a simple and useful predictor of well-developed CCC.

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Collateral circulation in coronary artery disease

Cited by 60 publications

References 23 publications

Potential protective effect of high coronary wedge pressure on left ventricular function after coronary occlusion.

Potential protective effect of high coronary wedge pressure on left ventricular function after coronary occlusion.

Determinants of coronary collateral circulation in patients with coronary artery disease

The relationship between ischaemia-modified albumin and good coronary collateral circulation

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