مرکز منطقه ای اطلاع رساني علوم و فناوري - Influence of clinical characteristics on coronary collaterals

Abstract :

Aim: The presence of coronary collaterals (CC) may exert a protective effect on outcome. Impaired collateral formation could be one of the reasons for increased risks of cardiovascular events. We aimed to determine the influence of clinical characteristics on the presence of CCs in patients with occlusive coronary artery disease. Materials and methods: This retrospective study enrolled one hundred and fourteen patients who had at least one total occlusion of a coronary artery on angiograms performed between July 2002 and December 2003 at the Department of Cardiology, Pamukkale University. CC flow was graded with Rentrop’s classification. Patients were divided in two groups: group 1 with well-developed collaterals and group 2 with less well-developed collaterals. Results: Demographic, clinical, and laboratory characteristics except the presence of q waves on ECG were similar between the two groups. The presence of q waves in leads V3-4 was associated with poor collateral development (p=0.028). Multivariate analysis determined that estimated glomerular filtration rate (eGFR) was independent predictor of collateral development (p=0.043). Lower eGFR was associated with well-developed collaterals. Conclusion: In patients with occlusive coronary artery disease, lower eGFR may positively influence the development of CCs. This adaptation may be especially beneficial for patients with lesser degrees of renal dysfunction, who are at greater risk of cardiovascular morbidity and mortality. Treatment modalities that impair the development and function of coronary collaterals should be used cautiously in these patients.