title: Presence of coronary collaterals in ST-elevation myocardial infarction patients does not affect long-term outcome.
abstract: BACKGROUND
  The significance of coronary collateral circulation in the prognosis of patients after myocardial infarction remains disputable.
  
  
  OBJECTIVE
  The aim of the study was to evaluate the effect of coronary collateral circulation, assessed by the Rentrop score, on long-term prognosis in patients treated with primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  Coronary collateral flow was assessed by angiography in 330 patients with myocardial infarction using the Rentrop score. Patients were followed up for the mean period of 26 ±12 months with the clinical endpoints of cardiac death, nonfatal reinfarction, and repeat percutaneous or surgical revascularization.
  
  
  RESULTS
  Collateral circulation was graded Rentrop 0 in 39%, Rentrop 1 in 36%, Rentrop 2 in 18%, and Rentrop 3 in 7% of the patients. The mortality rate was 8.7%. Reinfarction occurred in 4.7% of the subjects, and repeat coronary revascularization was performed in 10.9% of the patients. These endpoints were not correlated with the degree of collateral circulation. A significant inverse association was observed between the Rentrop score and the infarct-related artery antegrade flow (P <0.001).
  
  
  CONCLUSIONS
  The degree of collateral circulation assessed by the Rentrop score during primary PCI is not a useful long-term prognostic factor in the population with STEMI in the current therapeutic approach. This may result from the negative correlation between the Rentrop score and the degree of blood flow in the infarct-related artery. Thus, collateral circulation in a patient with STEMI should not discourage intensive cardiovascular risk factor control in secondary prevention of coronary artery disease.
authors.affiliation: Department of Cardiology, Medical University of Lodz, The Bieganski Hospital, Łódź, Poland. tomasz.rechcinski@umed.lodz.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rechciński
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Jasińska
authors.forename: Jan Z
authors.initials: JZ
authors.lastname: Peruga
authors.forename: Jakub
authors.initials: J
authors.lastname: Foryś
authors.forename: Maria
authors.initials: M
authors.lastname: Krzemińska-Pakuła
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Bednarkiewicz
authors.forename: Ewa
authors.initials: E
authors.lastname: Trzos
authors.forename: Jarosław D
authors.initials: JD
authors.lastname: Kasprzak
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D016896:Treatment Outcome