title: The clinical profile and outcomes associated with coronary collaterals in patients with coronary artery disease.
abstract: BACKGROUND
  The clinical correlates of coronary collaterals and the effects of coronary collaterals on prognosis are incompletely understood.
  
  
  METHODS
  We performed a study of 55,751 patients undergoing coronary angiography to evaluate the correlates of angiographically apparent coronary collaterals, and to evaluate their association with survival.
  
  
  RESULTS
  The characteristic most strongly associated with the presence of collaterals was a coronary occlusion (odds ratio [OR], 28.9; 95% confidence interval [CI], 27.1-30.6). Collaterals were associated with improved adjusted survival overall (hazard ratio [HR] 0.89; 95% CI, 0.85-0.95), and in both acute coronary syndrome (ACS) (HR 0.90; 95% CI, 0.84-0.96) and non-ACS (HR 0.84; 95% CI, 0.77-0.92) patients. Collaterals were associated with improved survival in those receiving angioplasty (HR 0.78; 95% CI, 0.71-0.85) and those with low risk anatomy treated medically (HR 0.84; 95% CI, 0.72-0.98), but not for those treated with coronary bypass graft surgery or those with high-risk anatomy treated without revascularization.
  
  
  CONCLUSIONS
  The major correlate of coronary collaterals is the presence/extent of obstructive coronary artery disease. Collaterals are associated with better survival overall and in both ACS and non-ACS presentations, but not for those treated with coronary artery bypass graft (CABG) or those with high-risk anatomy who are not revascularized.
authors: University of Alberta, Edmonton, Alberta, Canada. mcmurtry@ualberta.ca
authors: M Sean
authors: MS
authors: McMurtry
authors: Adriane M
authors: AM
authors: Lewin
authors: Merril L
authors: ML
authors: Knudtson
authors: William A
authors: WA
authors: Ghali
authors: P Diane
authors: PD
authors: Galbraith
authors: Felix
authors: F
authors: Schulte
authors: Colleen M
authors: CM
authors: Norris
authors: Michelle M
authors: MM
authors: Graham
mesh_terms: D000368:Aged; D003097:Collateral Circulation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged