Key result
Coronary collaterals show no significant benefit for in-hospital mortality or 30-day MACE in STEMI.
Why the study?
The distribution of coronary collaterals by Rentrop Collateral Score and its impact on in-hospital and 30-day mortality after primary PCI in STEMI needed assessment.
Does the presence of good coronary collaterals improve in-hospital and 30-day mortality and major adverse cardiovascular events (MACE) in STEMI patients undergoing primary PCI?
Cohort (n=347)
No
Does the presence of good coronary collaterals improve in-hospital and 30-day mortality and major adverse cardiovascular events (MACE) in STEMI patients undergoing primary PCI?
Absolute Event Rate: 2% vs 4.9%
p-value: p=0.248
The presence of good coronary collaterals in STEMI patients undergoing primary PCI is positively associated with prolonged ischemic time but does not significantly improve in-hospital or 30-day major adverse cardiovascular events.
Collateral presence should not guide acute STEMI management; leaves open prognostic value in larger or longer-term cohorts.
Objectives: This study aimed to determine the distribution of coronary collaterals (CC) as per the Rentrop Collateral Score (RCS) among patients with ST-segment elevation myocardial infarction (STEMI) and its impact on in-hospital and 30-day mortality after primary percutaneous coronary intervention (PCI). Methods: In this study, a selected sample of consecutive STEMI patients was assessed for the development of CC as per the RCS classification. An RCS grade of 2 or 3 was taken as the presence of CC with either partial or complete filling of the infarct-related artery (IRA). Patients were followed during the hospital stay and up to 30 days, and the incidence of major adverse cardiovascular events (MACE) was recorded, which included mortality, re-infarction, stroke, and hospitalization due to heart failure. Results: This study was conducted on a sample of 347 patients; 81.6% (283) were male, and the mean age was 56.2 ± 10.3 years. CC was not visible (RCS-0) in 206 (59.4%) patients, visible but without filling of the IRA (RCS-1) in 39 (11.2%) patients, and visible with partial (RCS-2) and complete (RCS-3) filling of the IRA in 72 (20.7%) and 30 (8.6%) patients, respectively. No significant differences were observed in the incidence of in-hospital mortality and short-term MACE between patients with and without CC, with an in-hospital mortality rate of 2% vs. 4.9% (p = 0.248) and a MACE rate of 7% vs. 6.4% (p = 0.850), respectively. Conclusion: Good CC with either partial or complete filling of the IRA was observed in more than one-fourth of the patients with STEMI. However, no significant benefits of good CC were observed.
No takes yet. Share an insight, caveat, or question.
Iqbal et al. (2024) conducted a cohort in ST-segment elevation myocardial infarction (n=347). Presence of coronary collaterals (Rentrop Collateral Score 2 or 3) vs. Absence of coronary collaterals (Rentrop Collateral Score 0 or 1) was evaluated on In-hospital mortality (p=0.248). The presence of coronary collaterals did not significantly reduce in-hospital mortality (2% vs 4.9%, p=0.248) or 30-day MACE among patients with STEMI undergoing primary PCI.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: