JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2002; 40:1545-1550
© 2002 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Billinger, M.
Right arrow Articles by Seiler, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Billinger, M.
Right arrow Articles by Seiler, C.

CLINICAL STUDY: CARDIAC CATHETERIZATION AND INTERVENTION

Physiologically assessed coronary collateral flow and adverse cardiac ischemic events: a follow-up study in 403 patients with coronary artery disease

Michael Billinger, MD*, Patrik Kloos, BS*, Franz R. Eberli, MD*, Stephan Windecker, MD*, Bernhard Meier, MD, FACC* and Christian Seiler, MD, FACC*,*

* Division of Cardiology, Swiss Cardiovascular Center Bern, Bern, Switzerland

Manuscript received March 11, 2002; revised manuscript received May 14, 2002, accepted June 7, 2002.

* Reprint requests and correspondence: Dr. Christian Seiler, Professor of Cardiology, University Hospital CH-3010 Bern, Switzerland.
christian.seiler.cardio{at}insel.ch

OBJECTIVES: We sought to evaluate whether coronary collateral flow is clinically relevant for future cardiac ischemic events.

BACKGROUND: The link between good collateral supply related to less myocardial damage and fewer cardiac events has not been established prospectively beyond doubt.

METHODS: In 403 patients with stable angina pectoris undergoing percutaneous transluminal coronary angioplasty (PTCA) and quantitative collateral assessment, the occurrence of major adverse cardiac events ([MACE] cardiac death, myocardial infarction, unstable angina pectoris) and stable angina pectoris was monitored during follow-up. Collateral flow index (CFI) was determined using intracoronary pressure or Doppler guidewires. Mean aortic ([Pao] mm Hg) and distal coronary artery occlusive pressure ([Poccl] mm Hg) during balloon angioplasty (PTCA), or distal coronary flow velocity time integral during ([Voccl] cm) and after ([Vø-occl] cm) PTCA were measured continuously. Pressure-derived CFI was calculated as follows: (Poccl – 5)/(Pao – 5). Doppler-derived CFI: Voccl/Vø-occl. Patients were subdivided into a group with well (CFI ≥ 0.25) and poorly developed collaterals (CFI < 0.25).

RESULTS: Average follow-up was 94 ± 56 (15 to 202) weeks. There were 134 patients with CFI ≥0.25 (61 ± 11 years) and 269 with CFI <0.25 (61 ± 10 years). The overall cardiac ischemic event rate (MACE and stable angina pectoris) during follow-up was 23% in patients with CFI ≥0.25 and 20% in patients with CFI <0.25 (p = NS). However, only 2.2% of patients with good collateral flow suffered a major cardiac ischemic event, compared with 9.0% among patients with poorly developed collaterals (p = 0.01). The incidence of stable angina pectoris was significantly higher in patients with well developed collaterals than in those with poorly developed collaterals (21% vs. 12%; p = 0.01).

CONCLUSIONS: In this relatively large population with chronic stable coronary artery disease undergoing quantitative collateral measurement, the beneficial impact of well developed collateral vessels on the occurrence of future major cardiac ischemic events is clearly demonstrated.

Abbreviations and Acronyms
  CAD
  coronary artery disease
  CFI
  collateral flow index
  CFIP
  pressure-derived index of collateral flow
  CFIV
  velocity-derived index of collateral flow
  CVP
  central venous pressure
  i.c.
  intracoronary
  MI
  myocardial infarct, myocardial infarction
  Pao
  mean aortic pressure
  Poccl
  coronary wedge pressure
  PTCA
  percutaneous transluminal coronary angioplasty
  Voccl
  ratio of flow velocity time integral distal to the occluded stenosis
  Vø-occl
  flow velocity time integral during vessel patency




This article has been cited by other articles:


Home page
 ANGIOLOGYHome page
H. Aslan, O. Turgut, K. Yalta, M. B. Yilmaz, R. Ozdemir, N. Ermis, A. T. Sezgin, E. Yetkin, I. Tandogan, and A. Yilmaz
Coronary Collateral Circulation: Any Effect on P-Wave Dispersion?
Angiology, August 1, 2008; 59(4): 448 - 453.
[Abstract] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
J. C. Velasquez-Castano and W. R. Taylor
Angiotensin II and New Vessel Formation: Aiming for the Right Oxidative Window
Arterioscler. Thromb. Vasc. Biol., January 1, 2008; 28(1): 4 - 5.
[Full Text] [PDF]

Home page
 CirculationHome page
P. Meier, S. Gloekler, R. Zbinden, S. Beckh, S. F. de Marchi, S. Zbinden, K. Wustmann, M. Billinger, R. Vogel, S. Cook, et al.
Beneficial Effect of Recruitable Collaterals: A 10-Year Follow-Up Study in Patients With Stable Coronary Artery Disease Undergoing Quantitative Collateral Measurements
Circulation, August 28, 2007; 116(9): 975 - 983.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
L. O. Jensen, P. Thayssen, J. F. Lassen, H. S. Hansen, H. Kelbaek, A. Junker, K. E. Pedersen, K. N. Hansen, L. R. Krusell, H. E. Botker, et al.
Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention
Eur. Heart J., August 1, 2007; 28(15): 1820 - 1826.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. Sezer, H. Oflaz, T. Goren, I. Okcular, B. Umman, Y. Nisanci, A. K. Bilge, Y. Sanli, M. Meric, and S. Umman
Intracoronary Streptokinase after Primary Percutaneous Coronary Intervention
N. Engl. J. Med., May 3, 2007; 356(18): 1823 - 1834.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
C. Berry, K. P. Balachandran, P. L. L'Allier, J. Lesperance, R. Bonan, and K. G. Oldroyd
Importance of collateral circulation in coronary heart disease
Eur. Heart J., February 1, 2007; 28(3): 278 - 291.
[Abstract] [Full Text] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
A. Buehler, M. A.M.J. van Zandvoort, B. J. Stelt, T. M. Hackeng, B. H.G.J. Schrans-Stassen, A. Bennaghmouch, L. Hofstra, J. P.M. Cleutjens, A. Duijvestijn, M. B. Smeets, et al.
cNGR: A Novel Homing Sequence for CD13/APN Targeted Molecular Imaging of Murine Cardiac Angiogenesis In Vivo
Arterioscler. Thromb. Vasc. Biol., December 1, 2006; 26(12): 2681 - 2687.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. J. Kern
Walking With Sir William: Reflections on Collateral Steal, Recruitment, and Ischemic Protection
J. Am. Coll. Cardiol., July 4, 2006; 48(1): 66 - 69.
[Full Text] [PDF]

Home page
 HeartHome page
D Perera, P Postema, R Rashid, S Patel, L Blows, M Marber, and S Redwood
Does a well developed collateral circulation predispose to restenosis after percutaneous coronary intervention? An intravascular ultrasound study
Heart, June 1, 2006; 92(6): 763 - 767.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
R Zbinden, S Zbinden, M Billinger, S Windecker, B Meier, and C Seiler
Influence of diabetes mellitus on coronary collateral flow: an answer to an old controversy
Heart, October 1, 2005; 91(10): 1289 - 1293.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
S. F. de Marchi, P. Oswald, S. Windecker, B. Meier, and C. Seiler
Reciprocal relationship between left ventricular filling pressure and the recruitable human coronary collateral circulation
Eur. Heart J., March 2, 2005; 26(6): 558 - 566.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
J. K. Olijhoek, J. Koerselman, P. P.Th. de Jaegere, M. C. Verhaar, D. E. Grobbee, Y. van der Graaf, F. L.J. Visseren, and for the SMART Study Group
Presence of the Metabolic Syndrome Does Not Impair Coronary Collateral Vessel Formation in Patients With Documented Coronary Artery Disease
Diabetes Care, March 1, 2005; 28(3): 683 - 689.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
K P Balachandran, C Berry, J Norrie, B D Vallance, M Malekianpour, T J Gilbert, A C H Pell, and K G Oldroyd
Relation between coronary pressure derived collateral flow, myocardial perfusion grade, and outcome in left ventricular function after rescue percutaneous coronary intervention
Heart, December 1, 2004; 90(12): 1450 - 1454.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. Perera, S. Biggart, P. Postema, S. Patel, P. Lambiase, M. Marber, and S. Redwood
Right atrial pressure: Can it be ignored when calculating fractional flow reserve and collateral flow index?
J. Am. Coll. Cardiol., November 16, 2004; 44(10): 2089 - 2091.
[Full Text] [PDF]

Home page
 CirculationHome page
H. M. Nathoe, E. Buskens, E. W.L. Jansen, W. J.L. Suyker, P. R. Stella, J. R. Lahpor, W.-J. van Boven, D. van Dijk, J. C. Diephuis, C. Borst, et al.
Role of Coronary Collaterals in Off-Pump and On-Pump Coronary Bypass Surgery
Circulation, September 28, 2004; 110(13): 1738 - 1742.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
M.H. Tayebjee, G.Y.H. Lip, and R.J. MacFadyen
Collateralization and the response to obstruction of epicardial coronary arteries
QJM, May 1, 2004; 97(5): 259 - 272.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
N. van Royen, M. Voskuil, I. Hoefer, M. Jost, S. de Graaf, F. Hedwig, J.-P. Andert, T.A.M. Wormhoudt, J. Hua, S. Hartmann, et al.
CD44 Regulates Arteriogenesis in Mice and Is Differentially Expressed in Patients With Poor and Good Collateralization
Circulation, April 6, 2004; 109(13): 1647 - 1652.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
S Zbinden, N Brunner, K Wustmann, M Billinger, B Meier, and C Seiler
Effect of statin treatment on coronary collateral flow in patients with coronary artery disease
Heart, April 1, 2004; 90(4): 448 - 449.
[Full Text] [PDF]

Home page
 HeartHome page
J A de Lemos and J J Warner
New tools for assessing microvascular obstruction in patients with ST elevation myocardial infarction
Heart, February 1, 2004; 90(2): 119 - 120.
[Full Text] [PDF]

Home page
 HeartHome page
C. Seiler
The human coronary collateral circulation
Heart, November 1, 2003; 89(11): 1352 - 1357.
[Full Text] [PDF]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2002 by the American College of Cardiology Foundation.