Key result
Coronary collateral circulation in AMI patients prevented excessive myocardial infarction size but had no obvious protective effect on 5-year MACE or heart function.
Why the study?
The short-term and long-term effects of coronary collateral circulation discovered after acute myocardial infarction remain debatable.
Does the presence of coronary collateral circulation improve long-term MACE, infarct size, and heart function in patients with acute myocardial infarction?
Cohort (n=1,662)
Does the presence of coronary collateral circulation improve long-term MACE, infarct size, and heart function in patients with acute myocardial infarction?
In patients with acute myocardial infarction, coronary collateral circulation reduces infarct size but fails to preserve left ventricular function or improve 5-year cardiovascular outcomes.
Collateral circulation should not guide AMI management; leaves open whether enhancing CCC improves long-term outcomes.
The short-term and long-term effects of coronary collateral circulation (CCC) discovered after acute myocardial infarction (AMI) are still debatable. This retrospective cohort study aimed to explore the clinical significance of CCC for AMI patients.A consecutive series of 323 AMI patients with CCC and 1339 AMI subjects without CCC were enrolled, most of them received percutaneous coronary intervention after AMI. Comparisons between CCC subjects and non-CCC population and between CCC sub-groups were applied regarded to basic clinical characteristics, stenosis extent indicated by Gensini score, myocardial infarction size estimated by peak concentration of troponin I (TnI), and left ventricular function evaluated by peak value of N-terminal pro-brain natriuretic peptide (NT-proBNP). Multiple linear regressions for NT-proBNP and TnI, and Kaplan-Meier curves for 5-years' main cardiovascular event (MACE) were also analyzed.CCC might provide incomplete protection by preventing excessive myocardial infarction but not a poorer heart function during AMI and CCC had no obvious protective effect on 5-years' MACE for AMI patients. More attentions should be paid to heart function for CCC patients during AMI.
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Liu et al. (2020) conducted a cohort in Acute myocardial infarction (n=1,662). Coronary collateral circulation vs. No coronary collateral circulation was evaluated on 5-year main cardiovascular event (MACE), myocardial infarction size, and left ventricular function. Coronary collateral circulation in AMI patients prevented excessive myocardial infarction size but had no obvious protective effect on 5-year MACE or heart function.
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