Key result
In patients with stable coronary artery disease, functional collateral perfusion was present in 45%, and angiographic signs of collaterals (Rentrop ≥1) predicted its presence (28% vs 8%; P=0.02).
Why the study?
What is the incidence of functional collateral perfusion and can angiographic signs predict it in patients with stable CAD scheduled for PCI?
Observational (n=89)
What is the incidence of functional collateral perfusion and can angiographic signs predict it in patients with stable CAD scheduled for PCI?
In patients with stable CAD undergoing PCI, 45% have functional collaterals, which can be modestly predicted by Rentrop's angiographic classification.
Answers are grounded in this paper and cite their sources.
Functional collaterals occur in nearly half of stable CAD cases; supports modest Rentrop prediction but leaves open any role in PCI decisions.
OBJECTIVES: To investigate the incidence and angiographic predictors of functional collateral perfusion in patients with stable coronary artery disease, scheduled for elective PCI. BACKGROUND: Functional collateral perfusion is defined as a Pw/Pa ratio>or=0.24. Since this can only be measured intracoronary, it is important to investigate baseline clinical and angiographic predictors for functional collateral perfusion. METHODS: Collateral perfusion was measured during balloon inflation, with the use of a pressure-monitoring guide wire. Baseline clinical and angiographic characteristics were analyzed and collateral grading was done according to Rentrop's classification for coronary angiograms. RESULTS: Functional collateral perfusion was found in 40 of the 89 patients (45%). Angiographic signs of collaterals (Rentrop>or=1) were present in 15 of the 89 patients. Of the 40 patients with the functional collateral perfusion 11 patients (28%) had Rentrop>or=1; of the 49 patients without functional collaterals there were 4 patients with Rentrop>or=1 (8%) (P=0.02). There were no significant differences in baseline clinical characteristics or in other angiographic characteristics. CONCLUSIONS: In patients with stable coronary artery disease scheduled for elective PCI, 45% have functional collaterals. Rentrop's angiographic classification can be used to predict the presence or absence of functional collaterals, however with a rather modest positive and negative predictive value.
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Vries et al. (2007) conducted an observational in Stable coronary artery disease (n=89). Rentrop's angiographic classification was evaluated on Presence of angiographic signs of collaterals (Rentrop ≥1) in patients with versus without functional collateral perfusion (p=0.02). In patients with stable coronary artery disease, functional collateral perfusion was present in 45%, and angiographic signs of collaterals (Rentrop ≥1) predicted its presence (28% vs 8%; P=0.02).
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