Relationship between collateral circulation and successful myocardial reperfusion in acute myocardial infarction: a subanalysis of the PREMIAR trial.
The aim of this study was to determine whether the presence of collateral circulation had a beneficial effect following primary angioplasty. In all, 114 patients who underwent primary angioplasty were included. Patients with collateral circulation had lower basal ST-segment deviation (P = .004), white cell count ( P = .001), peak creatine kinase (P = .001), and regional wall motion score values (P = .03) than patients without collateral circulation. After the procedure, the group with collaterals was associated with higher rates of normal myocardial blush, complete ST resolution, and shorter time to stable ST-recovery. Multivariable logistic analysis identified the presence of collateral circulation as independent predictor of normal myocardial blush (adjusted odds ratio = 3.98, 95% confidence interval, 1.12-14.09; P = .033) and rapid reperfusion (time to stable ST-segment recovery <7 minutes, adjusted odds ratio = 4.0, 95% confidence interval, 1.57-10.20; P = .004). The presence of collateral circulation has a protective effect on infarct size, resulting in faster reperfusion.
Albertal
Mariano
M
Department of Interventional Cardiology, Instituto Cardiovascular de Buenos Aires, Argentina. malbertal@fibertel.com.ar
Cura
Fernando
F
Escudero
Alejandro G
AG
Padilla
Lucio T
LT
Thierer
Jorge
J
Trivi
Marcelo
M
Belardi
Jorge A
JA
D015906:Angioplasty, Balloon, Coronary; D003097:Collateral Circulation; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000628:therapy*; D020127:Recovery of Function
D003402:Creatine Kinase