Key result
Good collateral flow fails to predict 6-month binary restenosis after primary angioplasty for AMI.
Why the study?
The influence of coronary collateral flow on restenosis after primary angioplasty for acute myocardial infarction was unclear.
Does good collateral flow reduce restenosis following primary angioplasty for acute myocardial infarction compared to poor collateral flow?
Cohort (n=156)
Does good collateral flow reduce restenosis following primary angioplasty for acute myocardial infarction compared to poor collateral flow?
Absolute Event Rate: 31.8% vs 32.9%
p-value: p=NS
Well-developed collaterals measured by PDCF do not predict restenosis following primary angioplasty for acute myocardial infarction.
Good collaterals by PDCF were not associated with lower restenosis after primary angioplasty in AMI; leaves open utility of collateral quantification for risk stratification.
We investigated the influence of collateral flow on restenosis in 156 consecutive acute myocardial infarction (AMI) patients treated with primary angioplasty within 12 hr of symptom onset. Collateral flow was quantitatively assessed using the pressure-derived fractional collateral flow (PDCF) index. Follow-up angiography was performed at 6 months. The patients were classified into two groups according to the PDCF index: group I (PDCF index > 24%; n = 55) with good collaterals and group II (PDCF index < or = 24%; n = 101) with poor collaterals. Baseline characteristics were similar between the two groups, with the exception of peak levels of creatine kinase, angiographic collaterals, and TIMI flow 3 after intervention. The binary restenosis rate was 31.8% in group I and 32.9% in group II (P = NS). Use of the stents was the only independent predictor of binary restenosis. In conclusions, well-developed collaterals measured by PDCF may not predict restenosis following primary angioplasty for AMI.
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Lee et al. (2002) conducted a cohort in Acute myocardial infarction (AMI) (n=156). Good collateral flow (PDCF index > 24%) vs. Poor collateral flow (PDCF index ≤ 24%) was evaluated on Binary restenosis (p=NS). Good collateral flow measured by PDCF index did not predict binary restenosis at 6 months following primary angioplasty for AMI compared to poor collateral flow (31.8% vs 32.9%, P=NS).
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