title: Coronary collateral circulation in patients with chronic coronary total occlusion; its relationship with cardiac risk markers and SYNTAX score.
abstract: BACKGROUND
  Compared to patients without a collateral supply, long-term cardiac mortality is reduced in patients with well-developed coronary collateral circulation (CCC). Cardiovascular risk markers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP) and high-sensitive cardiac troponin T (hs-cTnT) are independent predictors for cardiovascular mortality.
  
  
  OBJECTIVE
  The main goal of this study was to examine the relationship between CCC and cardiovascular risk markers.
  
  
  METHODS
  We prospectively enrolled 427 stable coronary artery disease patients with chronic total occlusion (mean age: 57.5±11.1 years). The patients were divided into two groups, according to their Rentrop scores: (a) poorly developed CCC group (Rentrop 0 and 1) and (b) well-developed CCC group (Rentrop 2 and 3). NT-proBNP, hs-CRP, hs-cTnT, uric acid and other biochemical markers were also measured. The SYNTAX score was calculated for all patients.
  
  
  RESULTS
  The patients in the poorly developed CCC group had higher frequencies of diabetes and hypertension (p<0.05 for both). Compared to the well-developed CCC group, the SYNTAX score, Hs-cTnT, hs-CRP, NT-proBNP, uric acid, neutrophil count and mean platelet volume (MPV) values were higher in patients with poorly developed CCC (p<0.05 for all). On multivariate logistic regression analysis, hs-cTnT (β=0.658, 95% CI=0.589-0.735, p<0.001) and NT-proBNP (β=0.991, 95% CI=0.987-0.995, p<0.001) as well as hs-CRP and diabetes were independent predictors of CCC.
  
  
  CONCLUSIONS
  Cardiac risk markers, such as NT-proBNP, hs-cTnT and hs-CRP are independently associated with CCC in stable coronary artery disease with chronic total occlusion.
authors.affiliation: Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Börekçi
authors.affiliation: Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey drmugur@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Gür
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Şeker
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: A O
authors.initials: AO
authors.lastname: Baykan
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Özaltun
authors.affiliation: Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Karakoyun
authors.affiliation: Department of Cardiology, Kafkas University School of Medicine, Kars, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Karakurt
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Türkoğlu
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Makça
authors.affiliation: Department of Cardiology, Dicle University School of Medicine, Adana, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Çaylı
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality / Q000503:physiopathology; D003326:Coronary Circulation; D054059:Coronary Occlusion / Q000097:blood / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
keywords: C-reactive protein; Rentrop; SYNTAX; brain natriuretic peptide; collateral circulation; high-sensitive troponin-T