What question did this study set out to answer?

To evaluate the influence of intercoronary collateral vessels on clinical characteristics, myocardial ischemia, and long-term outcomes in patients with coronary artery disease.

June 10, 1971New England Journal of Medicine

Functional Importance of the Human Coronary Collateral Circulation

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Why the study?

Does the presence of intercoronary collateral vessels affect clinical features and outcomes in patients with coronary-artery disease?

Population

119 patients with coronary-artery disease

Comparison

Presence of intercoronary collateral vessels vs Absence of arteriographically demonstrable…

Design

Cohort

Authors

RHRichard H. HelfantElectrophysiology PVPantel VokonasGeneral / Preventive / Lipids RGRichard GorlinAmerican College of Cardiology

Discussion

Member takes

Implication

Collateral presence links to more ischemia without reducing MI or death; leaves open their prognostic value pending prospective trials.

Key Points

To evaluate the influence of intercoronary collateral vessels on clinical characteristics, myocardial ischemia, and long-term outcomes in patients with coronary artery disease.
Compared 61 patients with arteriographically demonstrable coronary collateral vessels against 58 patients without detectable collateral vessels.
Evaluated physical activity levels, resting hemodynamic and ventriculographic abnormalities, post-exercise electrocardiograms, myocardial lactate production, and prospective rates of infarction and mortality.
Baseline physical activity, duration of angina, prior myocardial infarction rates, and resting hemodynamic or ventriculographic abnormalities were comparable between groups.
Patients with collateral vessels exhibited significantly greater myocardial ischemia, characterized by higher rates of abnormal post-exercise electrocardiograms and myocardial lactate production.
Incidence of acute myocardial infarction during follow-up was nearly identical between cohorts, and lower mortality in the collateral group did not reach statistical significance.

Structured PICO

Does the presence of intercoronary collateral vessels affect clinical features and outcomes in patients with coronary-artery disease?

Population

119 patients with coronary-artery disease

Intervention

Presence of intercoronary collateral vessels

Comparator

Absence of arteriographically demonstrable collateral vessels

Outcome

Clinical features of coronary-artery disease including physical activity, angina duration, prior MI, ECG/hemodynamic/ventriculographic abnormalities, myocardial ischemia, acute MI, and death

The presence of coronary collateral vessels is associated with more prevalent myocardial ischemia but does not significantly reduce the incidence of acute myocardial infarction or death.

Cite This Study

Helfant et al. (1971) studied this question.

synapsesocial.com/papers/69fe7956d8476229fea35829 https://doi.org/10.1056/nejm197106102842301

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Functional Importance of the Human Coronary Collateral Circulation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Functional Importance of the Human Coronary Collateral Circulation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider