Coronary Collateral Circulation in Patients of Coronary Ectasia with Significant Coronary Artery Disease
DOI:
https://doi.org/10.21276/2z2c2531Keywords:
Coronary ectasia, coronary collateral, stable coronary artery diseaseAbstract
Background:Patients with coronary ectasia (CE) usually have coexisting coronary stenosis resulting in myoischemia. Coronary collateral plays an important role in protecting myocardium from ischemia and reducing cardiovascular events. However, limited studies investigate the role of CE in coronary collaterals development.
Methods: We evaluated 838 consecutive patients undergoing coronary angiography and 251 patients with significant coronary artery disease (SCAD), defined as diameter stenosis more than 70%, were finally analyzed. CE is defined as the ectatic diameter 1.5 times larger than adjacent reference segment. Rentrop collateral score was used to classify patients into poor (grades 0 and 1) or good (grades 2 and 3) collateral group.
Results: 130 patients (51.7%) had CE lesions which were most located in the right coronary artery (58.4%). Patients with CE had a lower incidence of diabetes (33.0% vs 41.3%, p= 0.03), lower incidence of smoking (13.8% vs 27.2%, p=0.021), higher incidence of dyslipidaemia (32.3% vs 13.2%, 0.010) and poorer coronary collateral (85.0% vs 25.6%, p<0.0001). Patients with poor collateral (n= 142) had a higher incidence of CE (78% vs 17.4%, p<0.0001) and fewer diseased vessels numbers (1.76 vs 2.00, p,0.001). Multivariate analysis showed diabetes (odd ratio (OR) 0.630, p= 0.026), CE (OR= 2.44, p= 0.001), and number of diseased vessels (OR= 2.488, p=0.001) were significant predictors of coronary collaterals development.
Conclusion: The presence of CE was associated with poorer coronary collateral development in patients with SCAD.
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