title: Poor coronary collateral vessel development in patients with mild to moderate renal insufficiency.
abstract: BACKGROUND
  The development of coronary collaterals is crucial to survival through acute ischemia. Mild to moderate loss of renal function has been suggested to play a role in this event, but evidential data are scarce. The aim of this study was to investigate the relationship between mild to moderate renal insufficiency and coronary collateral development in patients with chronic total coronary artery occlusion.
  
  
  RESULTS
  A total of 83 patients with mild to moderate loss of renal function (30 mL/min/1.73 m(2) ≤ eGFR < 90 mL/min/1.73 m(2)) with chronic total coronary artery occlusion were included in our study. The collateral circulation was graded according to Rentrop classification and the function of collateral circulation was graded according to Werner collateral connection (CC) grades. Compared to patients with good collateral circulation (Rentrop = 2,3), eGFR was found to be lower in those patients with poor coronary collateral circulation (Rentrop = 0,1) (63.30 ± 10.51 vs. 54.13 ± 10.56, P = 0.02). eGFR was also found to be lower in poorly functioning coronary collateral circulation (CC = 0,1) than in efficiently functioning coronary collateral circulation (CC = 2) (55.22 ± 9.98 vs. 66.28 ± 9.16, P = 0.03). Multiple logistic regression analysis showed that low eGFR was independently associated with poor coronary collateral circulation (Rentrop = 0,1, 95% CI, 0.09-1.09, P = 0.044) and poor function of coronary collateral circulation (CC = 0,1, 95% CI, 0.02-0.17, P = 0.02).
  
  
  CONCLUSIONS
  Lower eGFR is associated with poorer coronary collateral vessel development in patients experiencing mild to moderate renal insufficiency. Moreover, eGFR represents an independent factor affecting coronary collateral vessel development.
authors.affiliation: Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, West Yanjiang Road 107, Guangzhou, People's Republic of China.
authors.forename: Shuang-lun
authors.initials: SL
authors.lastname: Xie
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Li
authors.forename: Bing-qing
authors.initials: BQ
authors.lastname: Deng
authors.forename: Nian-sang
authors.initials: NS
authors.lastname: Luo
authors.forename: Deng-feng
authors.initials: DF
authors.lastname: Geng
authors.forename: Jing-feng
authors.initials: JF
authors.lastname: Wang
authors.forename: Ru-qiong
authors.initials: RQ
authors.lastname: Nie
mesh_terms: D000368:Aged; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications*