title: Does claudication affect the development of coronary collaterals?
abstract: Atherothrombosis is a generalized disease process that affects large- and medium-diameter arteries throughout the arterial tree. In this study, we aimed to evaluate the correlation between collaterals in different vascular beds. Patients who had undergone digital subtraction angiography for symptomatic lower extremity peripheral arterial disease and coronary angiography after an acute anterior myocardial infarction (MI) were compared with a control group composed of those patients who were hospitalized for acute anterior MI and underwent coronary angiography but had no claudication and had an ankle-brachial index of greater than 0.9 in both legs. In claudicants, stenosis in the left anterior descending artery (LAD) (90.3 +/- 17.5 vs 78.6 +/- 13.8, P = 0.005) was greater compared with the patients without claudication. The collaterals to the LAD (88% vs 37.5%, P = 0.001) and the collateral grades (1.7 +/- 0.7 vs 0.7 +/- 0.9, P = 0.001) were higher in the patients with claudication compared with those without claudication. A previous history of angina (52.2% vs 16.3%, P = 0.001), claudication (39.1% vs 4.6%, P = 0.001), and peripheral collaterals (45.7% vs 6.9%, P = 0.001) were higher in the patients with coronary collaterals than in those without. The factors affecting the development of coronary collaterals were claudication [relative risk (RR): 8.8; 95% confidence interval (CI): 2.1-39.8], peripheral collaterals (RR: 1.1; 95% CI: 1.1-1.3), and LAD stenosis (RR: 1.2; 95% CI: 0.03-29.1). Our results suggest that the presence of collateralization or angiogenesis in one vascular bed highly predicts collateralization in another arterial bed.
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiology Clinics, Ankara, Turkey. drozdemir75@yahoo.com
authors.forename: Ozcan
authors.initials: O
authors.lastname: Ozdemir
authors.forename: Bilal
authors.initials: B
authors.lastname: Geyik
authors.forename: Ozgür
authors.initials: O
authors.lastname: Tosun
authors.forename: Mustafa
authors.initials: M
authors.lastname: Soylu
authors.forename: Ahmet Duran
authors.initials: AD
authors.lastname: Demir
authors.forename: Omer
authors.initials: O
authors.lastname: Alyan
authors.forename: Serkan
authors.initials: S
authors.lastname: Topaloglu
authors.forename: Dursun
authors.initials: D
authors.lastname: Aras
authors.forename: Hatice
authors.initials: H
authors.lastname: Saşmaz
authors.forename: Kemal
authors.initials: K
authors.lastname: Arda
authors.forename: Sule
authors.initials: S
authors.lastname: Korkmaz
mesh_terms: D001161:Arteriosclerosis / Q000453:epidemiology / Q000503:physiopathology; D003097:Collateral Circulation; D015897:Comorbidity; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology*; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000503:physiopathology*