title: Clinical and angiographic features associated with coronary collateralization in stable angina patients with chronic total occlusion.
abstract: OBJECTIVE
  Coronary collateral circulation is an alternative source of blood supply to myocardium in the presence of advanced coronary artery disease. We sought to determine which clinical and angiographic variables are associated with collateral development in patients with stable angina and chronic total coronary occlusion.
  
  
  METHODS
  Demographic variables, biochemical measurements, and angiographic findings were collected from 478 patients with stable angina and chronic total coronary occlusion. The presence and extent of collaterals supplying the distal aspect of a total coronary occlusion from the contra-lateral vessel were graded from 0 to 3 according to the Rentrop scoring system.
  
  
  RESULTS
  Low (Rentrop score of 0 or 1) and high (Rentrop score of 2 or 3) coronary collateralizations were detected in 186 and 292 patients, respectively. Despite similar age, cigarette smoking, and medical treatment, patients with low collateralization were female in a higher proportion and less hypertensive, and had higher rates of type 2 diabetes and dyslipidemia than those with high collateralization (for all comparisons, P<0.05). In addition, patients with low collateralization exhibited more single-vessel disease, less right coronary artery occlusion, more impaired renal function, and higher serum levels of high-sensitivity C-reactive protein (hsCRP) compared with those with high collateralization. Multivariate analysis revealed that age of ≥65 years, female gender, diabetes, no history of hypertension, dyslipidemia, moderate to severe renal dysfunction, single-vessel disease, and elevated hsCRP levels were independently associated with low coronary collateralization.
  
  
  CONCLUSIONS
  Coronary collateralization was reduced in almost 40% of stable angina patients with chronic total occlusion, which was related to clinical and angiographic factors. The impact of coronary collateralization on outcomes after revascularization needs further investigation.
authors.affiliation: Department of Cardiology, Shanghai Ruijin Hospital, Shanghai 200025, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Sun
authors.forename: Ying
authors.initials: Y
authors.lastname: Shen
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.forename: Rui-yan
authors.initials: RY
authors.lastname: Zhang
authors.forename: Li-jin
authors.initials: LJ
authors.lastname: Pu
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zheng-kun
authors.initials: ZK
authors.lastname: Yang
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.forename: Qiu-jing
authors.initials: QJ
authors.lastname: Chen
authors.forename: Wei-feng
authors.initials: WF
authors.lastname: Shen
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D003097:Collateral Circulation / Q000502:physiology; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012307:Risk Factors
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators
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