title: Predictor of poor coronary collaterals in chronic kidney disease population with significant coronary artery disease.
abstract: BACKGROUND
  Coronary collateral circulation plays an important role to protect myocardium from ischemia, preserve myocardial contractility and reduce cardiovascular events. Chronic kidney disease (CKD) is associated with poor coronary collateral development and cardiovascular outcome. However, limited research investigates the predictors for collateral development in the CKD population.
  
  
  METHODS
  We evaluated 970 consecutive patients undergoing coronary angiography and 202 patients with CKD, defined as a glomerular filtration rate less than 60 ml/min/1.73 m2, were finally analyzed. The collateral scoring system developed by Rentrop was used to classify patients into poor (grades 0 and 1) or good (grades 2 and 3) collateral group.
  
  
  RESULTS
  The patients with poor collateral (n = 122) had a higher incidence of hypertension (82% vs 63.8%, p = 0.005), fewer diseased vessels numbers (2.1 ± 0.9 vs 2.6 ± 0.6, p < 0.001) and a trend to be diabetic (56.6% vs. 43.8%, p = 0.085) or female sex (37.7% vs. 25.0%, p = 0.067). Multivariate analysis showed hypertension (odd ratio (OR) 2.672, p = 0.006), diabetes (OR 1.956, p = 0.039) and diseased vessels numbers (OR 0.402, p < 0.001) were significant predictors of poor coronary collaterals development. Furthermore, hypertension and diabetes have a negative synergistic effect on collateral development (p = 0.004 for interaction).
  
  
  CONCLUSIONS
  In the CKD population hypertension and diabetes might negatively influence the coronary collaterals development.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan, ROC.
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.forename: Suh-Hang
authors.initials: SH
authors.lastname: Juo
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Szu-Chia
authors.initials: SC
authors.lastname: Chen
authors.forename: Wei-chung
authors.initials: WC
authors.lastname: Tsai
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
mesh_terms: D000368:Aged; D003097:Collateral Circulation; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D012077:Renal Artery / Q000473:pathology*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology