Key result
Systemic endothelial function assessed by flow-mediated dilation of the brachial artery was not significantly associated with the extent of angiographically visible coronary collaterals (11.5% vs 10.4%, p=0.214).
Why the study?
Is systemic endothelial function assessed by brachial artery FMD associated with the extent of coronary collateral development in patients with severe coronary stenosis or occlusion?
Cross-Sectional (n=171)
Single-blind
No
Is systemic endothelial function assessed by brachial artery FMD associated with the extent of coronary collateral development in patients with severe coronary stenosis or occlusion?
Absolute Event Rate: 11.5% vs 10.4%
p-value: p=0.214
Systemic endothelial function assessed by brachial artery FMD is not significantly associated with the extent of angiographically visible coronary collaterals in patients with severe coronary stenosis.
No association between brachial FMD and coronary collaterals observed; hypothesis-generating for local endothelial mechanisms.
BACKGROUND: Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals. METHODS: We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms. RESULTS: Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (p = 0.001), but less likely to have used statins (p = 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 +/- 5.6 vs. 10.4 +/- 6.2% respectively, p = 0.214). Nitroglycerin mediated dilation was also similar (13.4 +/- 5.9 vs. 12.8 +/- 6.5%, p = 0.521). CONCLUSION: No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.
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Ongun et al. (2009) conducted a cross-sectional in High-grade coronary artery stenosis or occlusion (n=171). Good coronary collateral development (Rentrop grades 2-3) vs. Poor coronary collateral development (Rentrop grades 0-1) was evaluated on Endothelium-dependent flow-mediated dilation (FMD) of the brachial artery (p=0.214). Systemic endothelial function assessed by flow-mediated dilation of the brachial artery was not significantly associated with the extent of angiographically visible coronary collaterals (11.5% vs 10.4%, p=0.214).
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