title: Clinical parameters associated with collateral development in patients with chronic total coronary occlusion.
abstract: OBJECTIVE
  Well-developed collaterals provide survival benefit in patients with obstructive coronary artery disease (CAD). Therefore, in this study we sought to determine which clinical variables are associated with arteriogenesis.
  
  
  METHODS
  Clinical and laboratory variables were collected before percutaneous coronary intervention. Multivariate analysis was performed to determine which variables are associated with the collateral flow index (CFI).
  
  
  METHODS
  Data from 295 chronic total occlusion (CTO) patients (Bern, Switzerland, Amsterdam, the Netherlands and Jena, Germany) were pooled. In earlier studies, patients had varying degrees of stenosis. Therefore, different stages of development of the collaterals were used. In our study, a unique group of patients with CTO was analysed.
  
  
  METHODS
  Instead of angiography used earlier, we used a more accurate method to determine CFI using intracoronary pressure measurements. CFI was calculated from the occlusive pressure distal of the coronary lesion, the aortic pressure and central venous pressure.
  
  
  RESULTS
  The mean CFI was 0.39 ± 0.14. After multivariate analysis, β blockers, hypertension and angina pectoris duration were positively associated with CFI (B: correlation coefficient β=0.07, SE=0.03, p=0.02, B=0.040, SE=0.02, p=0.042 and B=0.001, SE=0.000, p=0.02). Furthermore also after multivariate analysis, high serum leucocytes, prior myocardial infarction and high diastolic blood pressure were negatively associated with CFI (B=-0.01, SE=0.005, p=0.03, B=-0.04, SE=0.02, p=0.03 and B=-0.002, SE=0.001, p=0.011).
  
  
  CONCLUSIONS
  In this unique cohort, high serum leucocytes and high diastolic blood pressure are associated with poorly developed collaterals. Interestingly, the use of β blockers is associated with well-developed collaterals, shedding new light on the potential action mode of this drug in patients with CAD.
authors.affiliation: Department of Cardiology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands. nw.vanderhoeven@gmail.com
authors.forename: N W
authors.initials: NW
authors.lastname: van der Hoeven
authors.forename: P F
authors.initials: PF
authors.lastname: Teunissen
authors.forename: G S
authors.initials: GS
authors.lastname: Werner
authors.forename: R
authors.initials: R
authors.lastname: Delewi
authors.forename: S H
authors.initials: SH
authors.lastname: Schirmer
authors.forename: T
authors.initials: T
authors.lastname: Traupe
authors.forename: A M
authors.initials: AM
authors.lastname: van der Laan
authors.forename: J G
authors.initials: JG
authors.lastname: Tijssen
authors.forename: J J
authors.initials: JJ
authors.lastname: Piek
authors.forename: C
authors.initials: C
authors.lastname: Seiler
authors.forename: N
authors.initials: N
authors.lastname: van Royen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D062186:Arterial Pressure; D002496:Central Venous Pressure; D015331:Cohort Studies; D003097:Collateral Circulation; D015897:Comorbidity; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000503:physiopathology; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000379:methods; D019990:Perioperative Care / Q000379:methods / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: CORONARY ARTERY DISEASE