Coronary collateral circulation: The effects of smoking and alcohol

Objective The presence or absence of coronary collaterals is of vital importance during acute ischemia. Smoking and alcohol have been suggested to play a role, but data are scarce. We examined the extent to which smoking and alcohol use affect the presence of coronary collateral circulation. Methods Cross-sectional study in 242 patients, admitted for elective PTCA. Smoking was defined as past or current. Packyears were calculated and categorized into never-smokers (reference-category): <10, 10–19, 20–29, and ≥30 packyears. Alcohol consumption was defined as past or current, and categorized into never-users (reference-category): <1, 1–10, 11–20, and ≥21 units per week (UPW). Collaterals were graded with Rentropʹs classification. Coronary collateral presence was defined as Rentrop-grade ≥1. Results Current smoking (odds ratio (OR) 4.17; 95% confidence interval (CI) 1.79–9.71) was positively associated, while packyears of smoking was not related. Current alcohol intake showed a J-shaped tendency with coronary collateral presence, while past moderate alcohol consumption was inversely associated (OR 0.19; 95% CI 0.04–0.98). Conclusions Smoking and (to some extent) alcohol use are associated with collateral presence. The results support the view that life-style factors may affect the formation of coronary collaterals in patients with ischemic cardiac disease.