A Study of Coronary Collateral Circulation in Coronary Artery Disease Volume 3 - Issue 4

Sanjeev Asotra¹, Kavita Negi², Rajesh Sharma¹, P.C Negi¹ and K S Sood³

• ¹Department of cardiology, I.G.M.C Shimla, H.P India
• ²Department of Anatomy, I.G.M.C Shimla, H.P India
• ³3Department of Anatomy, I.G.M.C Shimla, H.P India

Received:April 23, 2021;   Published: May 3, 2021

Corresponding author: Dr Sanjeev Asotra, Department of Cardiology, I.G.M.C Shimla. H.P India

DOI: 10.32474/ACR.2021.03.000166

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Abstract

Coronary artery disease is an important global cause of morbidity and mortality and high prevalence is found in the Indian population. Collaterals developed in coronary arteries help in the protection of the myocardium from infarction, preservation of ventricular functions, and thus reducing cardiovascular events. The objective of this study is to assess the prevalence, clinical predictors of coronary collaterals, relationship with severity of coronary artery disease, regional wall motion abnormality, and left ventricular global ejection fraction.

Methods: 302 consecutive coronary angiograms of patients of clinical diagnosis of coronary artery disease were analyzed. Focused clinical history, demographic profile, and risk factors were analyzed. Medical history focused on chronic stable angina, past myocardial infarction unstable angina and acute myocardial infarction was taken. Collateral vessels were analyzed according to Rentrop classification.

Results: Prevalence of coronary collaterals was seen in 74% of patients with luminal diameter stenosis of >50%. Grade 1 collaterals were observed in 26.5%, Grade 2 in 27.8%, and Grade 3 in 19.8%. 51.7 % of patients had intracoronary, 23.3 % had intracoronary and 25% of patients had both inter and intracoronary collaterals.

Conclusions: The prevalence of coronary collaterals is high in obstructive coronary artery disease. There was no association of collaterals with age, sex, chronic stable angina, unstable angina, and Myocardial infarction. The severity of coronary artery disease had an independent significant association with the presence of collaterals. There was a significant correlation of grade of collaterals with regional wall motion abnormality and with left ventricular global ejection fraction.

Keywords: Coronary collaterals; Coronary artery disease; Coronary angiography; LAD; LCxA; RCA; BMI; EF; RWMA

Abstract| Introduction| Material and Methods| Statistical Analysis| Results| Discussion| References|