Key result
In patients with ST-elevation myocardial infarction, good coronary collateral circulation was not significantly associated with a reduction in major adverse cardiac events at 30 days compared to poor collateral circulation (OR 3.9, 95% CI 0.5-30.5).
Why the study?
The impact of good coronary collateral circulation on mortality remains debated, particularly in ACS.
Does good coronary collateral circulation reduce major adverse cardiac events in patients with STEMI undergoing PCI?
Cohort (n=200)
Does good coronary collateral circulation reduce major adverse cardiac events in patients with STEMI undergoing PCI?
Answers are grounded in this paper and cite their sources.
In contrast to previous assumptions, good coronary collateral circulation did not significantly reduce 30-day major adverse cardiac events or mortality in STEMI patients undergoing PCI.
Background: The presence of good coronary collateral circulation (CCC) can protect and preserve myocardium from ischemia, increase myocardial contractility, and reduce adverse clinical events. However, its impact on mortality is still a topic of debate, particularly in acute coronary syndrome (ACS). The aim of this study was to investigate the association of CCC with cardiac risk factors and in-hospital mortality in patients hospitalized with a diagnosis of ACS. Methods: The study population included 200 patients with ST – elevation myocardial infrarction who underwent coronary angiography and were found to have TIMI flow coronary 0 or 1. The CCC was graded according to the Rentrop classification. The patients were classified into a poor CCC group (Rentrop grades 0-1, n=161) or a good CCC group (Rentrop grades 2-3, n=39). Following of major adverse cardiac events about 30day after PCI. RESULTS: Patients with good CCC had time onset chest pains (p = 0,001), higher rate of Killip class of at least 2 at admission (p = 0,031), peak troponin T (p = 0,037), lacticemia lower (p = 0,03), multivessel lesion upper (p = 0,03) with the patients with poor CCC. MACE of patients with good CCC nosignificant with the patient with poor CCC (OR=3,9, 95%CI[0,5- to 30,5], mortality (HR 2,5, 95%CI[0,31-19,2], p=0,45), unplanned target vessel revascularisation (TVR) (HR 28,8 (0.006 to 1.4), p=0.44), comelack in-hospital by cardiovascular causes (HR 1,06, 95%CI[0,29 to 3,7]. P=0,93). Increase left ventricular ejection fraction after 30day in patients with good CCC upper patients with poor CCC (p=0,004). CONCLUSION: In contrast to previous studies, our study did not confirm a beneficial role of good CCC in patients with ST – elevation myocardial infarction. The presence of good CCC was even independently associated NYHA grades, Killip grades, peak troponin T, lacticemia and left ventricular ejection fraction.
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Hoan et al. (2022) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=200). Good coronary collateral circulation (Rentrop grades 2-3) vs. Poor coronary collateral circulation (Rentrop grades 0-1) was evaluated on Major adverse cardiac events (MACE) at 30 days (OR 3.9, 95% CI 0.5-30.5). In patients with ST-elevation myocardial infarction, good coronary collateral circulation was not significantly associated with a reduction in major adverse cardiac events at 30 days compared to poor collateral circulation (OR 3.9, 95% CI 0.5-30.5).
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