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Can J Cardiol. 2011 Sep-Oct;27(5):581-8. doi: 10.1016/j.cjca.2011.02.011. Epub 2011 Jul 13.

The clinical profile and outcomes associated with coronary collaterals in patients with coronary artery disease.

Author information

1
University of Alberta, Edmonton, Alberta, Canada. mcmurtry@ualberta.ca

Abstract

BACKGROUND:

The clinical correlates of coronary collaterals and the effects of coronary collaterals on prognosis are incompletely understood.

METHODS:

We performed a study of 55,751 patients undergoing coronary angiography to evaluate the correlates of angiographically apparent coronary collaterals, and to evaluate their association with survival.

RESULTS:

The characteristic most strongly associated with the presence of collaterals was a coronary occlusion (odds ratio [OR], 28.9; 95% confidence interval [CI], 27.1-30.6). Collaterals were associated with improved adjusted survival overall (hazard ratio [HR] 0.89; 95% CI, 0.85-0.95), and in both acute coronary syndrome (ACS) (HR 0.90; 95% CI, 0.84-0.96) and non-ACS (HR 0.84; 95% CI, 0.77-0.92) patients. Collaterals were associated with improved survival in those receiving angioplasty (HR 0.78; 95% CI, 0.71-0.85) and those with low risk anatomy treated medically (HR 0.84; 95% CI, 0.72-0.98), but not for those treated with coronary bypass graft surgery or those with high-risk anatomy treated without revascularization.

CONCLUSIONS:

The major correlate of coronary collaterals is the presence/extent of obstructive coronary artery disease. Collaterals are associated with better survival overall and in both ACS and non-ACS presentations, but not for those treated with coronary artery bypass graft (CABG) or those with high-risk anatomy who are not revascularized.

PMID:
21742466
DOI:
10.1016/j.cjca.2011.02.011
[Indexed for MEDLINE]

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