title: Coronary collateral circulation: the effects of smoking and alcohol.
abstract: OBJECTIVE
  The presence or absence of coronary collaterals is of vital importance during acute ischemia. Smoking and alcohol have been suggested to play a role, but data are scarce. We examined the extent to which smoking and alcohol use affect the presence of coronary collateral circulation.
  
  
  METHODS
  Cross-sectional study in 242 patients, admitted for elective PTCA. Smoking was defined as past or current. Pack years were calculated and categorized into never-smokers (reference-category): <10, 10-19, 20-29, and >or=30 pack years. Alcohol consumption was defined as past or current, and categorized into never-users (reference-category): <1, 1-10, 11-20, and >or=21 units per week (UPW). Collaterals were graded with Rentrop's classification. Coronary collateral presence was defined as Rentrop-grade >or=1.
  
  
  RESULTS
  Current smoking (odds ratio (OR) 4.17; 95% confidence interval (CI) 1.79-9.71) was positively associated, while pack years of smoking was not related. Current alcohol intake showed a J-shaped tendency with coronary collateral presence, while past moderate alcohol consumption was inversely associated (OR 0.19; 95% CI 0.04-0.98).
  
  
  CONCLUSIONS
  Smoking and (to some extent) alcohol use are associated with collateral presence. The results support the view that life-style factors may affect the formation of coronary collaterals in patients with ischemic cardiac disease.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (UMC Utrecht), HP Str. 6.131, Heidelberglaan 100, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Koerselman
authors.forename: Peter P Th
authors.initials: PP
authors.lastname: de Jaegere
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Verhaar
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000800:Angioplasty, Balloon; D015331:Cohort Studies; D003097:Collateral Circulation / Q000502:physiology*; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects* / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012907:Smoking / Q000009:adverse effects*