Key result
Patients without transmural MI demonstrate a ~2.8-fold higher collateral index than those with acute MI.
Why the study?
The role of coronary collateral perfusion in preserving myocardial integrity during acute coronary occlusion and the influence of long-standing angina on collateral development were unclear.
Is well-developed coronary collateral perfusion associated with preserved myocardial integrity upon acute coronary occlusion?
Observational (n=32)
Is well-developed coronary collateral perfusion associated with preserved myocardial integrity upon acute coronary occlusion?
Absolute Event Rate: 2.5% vs 0.9%
p-value: p=<0.01
Well-developed coronary collateral vessels preserve myocardial integrity upon acute coronary occlusion, and long-standing angina may play a role in developing these collateral channels.
Greater collaterals may limit transmural infarction in ACS; hypothesis-generating for collateral promotion but requires prospective trials.
Coronary collateral perfusion to the completely obstructed coronary artery was evaluated by coronary cineangiography in 32 patients. In 13 patients, there was neither history of severe chest pain of longer than 30-min duration nor electrocardiographic evidence of a transmural myocardial infarction (Group I). Among patients undergoing intracoronary thrombolytic therapy for the completely occluded infarct-related coronary artery within 6 h after the onset of symptoms of the first acute myocardial infarction, 19 patients had a history of preinfarction angina (Group II). Collateral visualization (collateral index) was found to be significantly greater in Group I (2.5 +/- 0.5, SD) than in Group II (0.9 +/- 1.0) (p less than 0.01). Group I patients had a longer history of angina (25 +/- 25 months) than did Group II patients (17 +/- 18 months) (p = NS). These findings indicate that well-developed coronary collateral vessels preserve myocardial integrity upon acute coronary occlusion and that a long-standing angina indicative of myocardial ischemia may play an important role in developing collateral channels.
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Fujita et al. (1987) conducted an observational in Completely obstructed coronary artery (n=32). Absence of transmural myocardial infarction vs. Acute myocardial infarction was evaluated on Collateral index (p=<0.01). Patients without transmural myocardial infarction had a significantly greater collateral index compared to those with acute myocardial infarction (2.5 vs 0.9; p<0.01).
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